Tag Archive for: nursing

Clinical Epidemiology

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 Introduction to Clinical Epidemiology (401173)
FINAL ASSIGNMENT
Autumn, 2019
Due date: 11.59pm , May 29 2019
This assignment is based on the learning objectives and concepts as  described in the Unit Learning Guide. There are 9 questions worth a  total of 64 marks and this assignment will contribute 64% towards the  total assessment for this subject.
Your assignment should be typed, with adequate space left between  questions. Assignments should be submitted via vUWS. Be as concise as  possible in your answers, and use the number of marks allocated to each  question as a guide for how much to write.
Please note this is an individual exercise.
Late assignments will not be accepted without prior approval.
You are required to answer ALL questions (1-9)
Page 1 of 7
Answer questions 1-2 based on the following scenarios:
Q1: Fred, a 65-year-old obese man with a history of type 2 diabetes  mellitus and hypertension presents to the GP practice for a follow-up  appointment. During the consultation, he asks whether there is a better  medication to glicazide and metformin, his oral hypoglycemic  medications, which he has been taking to control his blood sugar. His  friend has recently been put on a newer oral hypoglycemic medication  (Liraglutide, a glucagon-like peptide-1 analogue), which has been shown  to help with weight management in patients with diabetes and obesity.  Fred has been finding it very difficult to lose weight for a few years  now as he has tried various lifestyle modifications. He asks whether the  new oral hypoglycemic medications could be an option for him in weight  reduction.
Task [2 marks]
a. Write a focused research question for this particular problem that  will help you organise a search of the literature for an answer (use the  PICO elements as appropriate).
b. Identify the PICO elements in your research question
Q2: In the past 2 years, as an Infectious Disease Specialist in one of  the tertiary hospitals in Australia, you have attended to 23 migrant  patients who were referred by their General Practitioners with symptoms  not typical of pulmonary tuberculosis. After taking a detailed history  and performing appropriate physical examinations, as well as reviewing a  range of relevant investigations, you clinically diagnosed and  microbiologically confirmed that those patients have multi-drug  resistance pulmonary tuberculosis (MDR-TB). The Public Health Department  was notified of disease and the patients were managed accordingly. Now,  you and some colleagues from Western Sydney University want to  investigate the risk factors for MDR-TB.
Task [2 marks]
a. Write a focused research question for this particular problem that  will help you organise a search of the literature for an answer (use the  PICO elements as appropriate).
b. Identify the PICO elements in your research question
Q3: Please select the single best answer for each of questions 3.I – VII
I. Randomised controlled trials provide strong evidence that an observed  effect is due to the intervention. One main reason is because [1 mark]:
a) When the study participants are randomised, many characteristics and  potential confounders are likely to be evenly distributed in the groups
b) It is easier to measure the outcome variable with great precision in  randomised controlled trials compared to other study designs.
c) The exposure level and the outcome are measured at the same time
d) The study participants are volunteers and therefore motivated to take part in the study
e) None of the above
II.Blinding is an important feature of a randomised controlled trials because [1 marks]:
a) It helps prevent measurement bias – the biased assessment of outcomes
b) It helps reduce contamination and compliance problems
c) It helps reduce confounding and selection bias
d) It is required to do an intention-to-treat analysis
e) It helps improve chance event and reduce misclassification III. Which of the following is true [1 mark]?
a) Loss to follow-up can lead to selection bias in cohort studies.
b) Selection bias can arise from conditioning on the common effect of  the exposure and an uncontrolled independent risk factor for the  outcome.
c) Case-control studies are no more prone to selection bias than are cohort studies.
d) Loss to follow-up is not a major source of bias in cohort studies.
e) None of the above.
IV. When epidemiologists judge the evidence to establish a possible cause of a health outcome, they
consider [1 mark]:
a) The strength of the association between an exposure and the outcome
b) Evidence that the exposure of interest has appeared before the outcome.
c) Evidence showing that reductions in the exposure level will reverse the risk of the outcome.
d) A, B and C
e) A and B only
V. A double-blind study was designed to test the efficacy of a drug. One  group of the patients consisting of 1227 participants were given a  placebo and the other group of patients consisting of 1220 were given  the active drug. Both groups were to be followed up for one year. After  6-months of the trial, 35% of participants in the placebo groups dropped  out of the study and 4% of the participants taking the active drug  dropped out of the study. What is the SINGLE BEST explanation for this  occurrence [1 mark]?
a) Failure of the active drug
b) Insufficient information to interpret data
c) Systematic error
d) Chance event
e) Breakdown of the double-blind study
VI. The highest level of evidence provided for cancer treatment usually comes from: [1 mark]
a) Randomised control trials
b) Phase II clinical trials
c) Phase III clinical trials
d) Systematic reviews of observational studies
e) Meta-analyses of intervention studies
Page 3 of 7
VII. A recent study examined the association between tea consumption and  ovarian cancer. The study included 414 women with primary epithelial  ovarian, fallopian, or peritoneal cancer and 868 age-and region-matched  women with non-neoplastic conditions. The adjusted odds ratio was 0.39  for those drinking tea daily and 0.23 for those drinking tea for 30  years, compared with non-tea drinkers. The study concluded that  increasing frequency and duration of tea drinking, especially green tea,  can reduce the risk of ovarian cancer.
What type of study was conducted? [1 mark]
a) Cross-sectional study
b) Prospective cohort study
c) Randomised controlled trial
d) Retrospective cohort study
e) Case control study
Q4: Now select ONLY ONE research question from either Question 1 or 2  above that will help you organize a search of the clinical literature  for an answer. If you were to search Medline/PubMed/Web of science for  original research on this question:
a. Describe what your search strategy would be, including keywords, MeSH  terms, inclusion and exclusion criteria, as well as evidence of the  Boolean operators used [4 marks].
b. What type of study design would best be able to address your selected research question? State why [1 mark].
c. Cite the best article from among those you find, using any referencing style of your choice [1 mark].
Q5: Answer questions 5a-b based on the following information:
A total of 1800 patients have a screening test to identify a protein  called “FEN-59’ to determine patients at risk of lung carcinoma,  followed by a standardized lung biopsy procedure. Of the 1800 children,  1533 have a negative FEN-59 and 267 have a positive FEN-59. In addition,  a lung biopsy (gold standard) was done on all patients. Of those  patients with a negative FEN-59, 1491 have a negative lung biopsy. In  the group with a positive FEN-59, 259 have a positive lung biopsy.
Construct a 2×2 table using the information provided above, and answer the following questions (a and b):
a) Calculate the sensitivity of the FEN-59 [2 marks]
b) Calculate the positive predictive value of the FEN-59 [2 marks]
c) The negative predictive value is dependent on all of the following:  prevalence, incidence, sensitivity and specificity [True/False] [1 mark]
Please select the SINGLE BEST answer in questions 5e to f
d) Using the image below, which value in the test result units is the point of maximum specificity? [1 mark]
a) 30
b) 15
c) 5
d) 20
e) 25
e) A study was conducted in which 10,000 women participated. All women  underwent a cervical smear. 1,000 of 10,000 women had a positive smear.  Of these, 100 developed cervical cancer. 10 women who had negative smear  developed cancer. What is the SINGLE most likely terminology to  describe the 10 women with negative results who developed cervical  cancer?
[1 mark]
a. True negative
b. False negative
c. True positive
d. False positive
e. Chance event
Q6: Answer questions 6a-d based on the following information:
You have brought to the attention of the hospital medical services that a  published trial reported reduced body weight in patients with morbid  obesity who were treated with liraglutide, a glucagon-like peptide-1  equivalent. You mentioned this published paper to your Director, and  given the evidence reported, he asked you to give a presentation about  the study findings during the weekly seminar series. In your  presentation, she has asked you to address the following questions  (6a-d) based on the results of the published paper (Edited abstract is  shown below):
A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight  Management (Xavier Pi-Sunyer, M.D., Arne Astrup, M.D., D.M.Sc., Ken  Fujioka et al. N Engl J Med 2015;373:11-22.
DOI: 10.1056/NEJMoa1411892)
Background: Obesity is a chronic disease with serious health  consequences, but weight loss is difficult to maintain through lifestyle  intervention alone. Liraglutide, a glucagonlike peptide-1 analogue, has  been shown to have potential benefit for weight management at a  once-daily dose of 3.0 mg, injected subcutaneously.
Methods: We conducted a 56-week, double-blind trial involving 3731  patients who did not have type 2 diabetes and who had a body-mass index  of at least 30 or a BMI of at least 27 if they had treated or untreated  dyslipidemia or hypertension. We randomly assigned patients in a 2:1  ratio to receive once-daily subcutaneous injections of liraglutide at a  dose of 3.0 mg (2487 patients) or placebo (1244 patients); both groups  received counselling on lifestyle modification.
Results: At week 56, patients in the liraglutide group had lost a mean  of 8.4±7.3 kg of body weight, and those in the placebo group had lost a  mean of 2.8±6.5 kg (a difference of -5.6 kg; 95% confidence interval,  -6.0 to -5.1; P 0.001). A total of 63.0% of the patients in the  liraglutide group as compared with 37.0% in the placebo group lost at  least 5% of their body weight (P 0.001).
Conclusion: In this study, 3.0 mg of liraglutide, as an adjunct to diet  and exercise, was associated with reduced body weight and improved  metabolic control.
Q6a. Construct a 2×2 table using relevant figures shown in the abstract, and answer the following questions: [4 marks]
(i) What is the risk of losing at least 5% of body weight in all patients included in the study?
(ii) What is the risk of losing at least 5% of body weight in patients who were treated with liraglutide?
(iii) What is the risk of losing at least 5% of body weight in patients who were treated with placebo?
(iv) What is the relative risk of treatment with liraglutide verus  placebo with regard to weight management? How would you interpret this  relative risk estimate?
Q6b. If equal numbers of patients in the population were treated with  liraglutide vs placebo treatment, what would be the expected population  relative risk reduction (RRR) for liraglutide treatment? How would you  interpret this measure? [4 marks]
Q6c. How many patients need to be treated with liraglutide for one more  patient to benefit compared with the placebo? What is this measure  called? How would you interpret this measure [4 marks]?
Q6d. How does the measure in question 5b differ from question 5c? [4 marks]
Read the attached original research article (Khorana et al., 2019), available in vUWS), and now answer Questions 7 to 9:
Q7. What characteristics of the study would you consider in order to  determine if its findings are valid? Include wider considerations of  study quality/validity and give examples. (Q8 will address relevance,  and the next question will ask how to determine the importance of the  findings…for this question, focus on the internal validity of the study)  [8 marks]
Q8. What characteristics of the findings would you consider, in order,  to determine if they are clinically meaningful and statistically  significant? Include examples. (You’ve already addressed validity…for  this question, focus on how to determine the clinical significance and  statistical significance of an effect reported in the study) [8 marks]
Q9. What characteristics of the study would you consider, in order, to  determine if it is generalizable to your context? Explain your answers  and provide examples. (Questions 6 and 7 have asked how to determine if  the study is valid, and how important the findings are….for this  question, focus on how to determine if it is really relevant or  generalizable to your practice.) [8 marks]
Note:
0 Please do not list the characteristics in questions 8–10, but explain your answers succinctly.
0 You can also download the article from the University Library using your student login details.

health beliefs

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Read chapter 6 and 7 of the class textbook.  Once done answer the following questions;

1.  Describe the health beliefs of the African American and Amish people and how they are differ

2.  Mention the difference between the African American and the Amish communities regarding health care.

3.  If there any similarity between the African American and the Amish population.

As always your assignment in an APA format.  Assignment must be presented in an Arial 12 font with at least 3 evidence based references. A minimum of 500 words are required.

due date: Saturday, sept 16, 2017 at 2:00pm

Collaborative Learning Community

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This is a Collaborative Learning Community (CLC) assignment.

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10-15 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:

  1. Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.
  2. Explain how the nursing theory incorporates the four metaparadigm concepts.
  3. Provide three evidence-based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.

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.

Asthma

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Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.

One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

To Prepare
  • Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
  • Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
  • Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
  • Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
  • Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
  • Explain the stepwise approach to asthma treatment and management for your patient.
  • Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.the disease.
  • Please review the rubric for this assignment.

Rubric:

The presentation clearly and accurately describes in detail the long-term control and quick relief treatment options for the asthma patient from their practice.

The presentation clearly and accurately describes in detail the impact these drugs might have on their patient.

The presentation clearly and accurately explains in detail the stepwise approach to asthma treatment and management for their patient.

The presentation clearly and accurately explains in detail how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

The presentation provides accurate and detailed examples to support the explanation provided.

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

Uses correct grammar, spelling, and punctuation with no errors

References:

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

  • Chapter 60, “Drugs for Asthma and Chronic Obstructive Pulmonary Disease” (pp. 673–693)
  • Chapter 61, “Drugs for Allergic Rhinitis, Cough, and Colds” (pp. 695–702)

real-world nursing issue

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Course Project Milestone 1 Guidelines and Grading Rubric

Updated 01/2019

Purpose

To apply lessons in quality improvement in nursing to a real-world nursing issue. This Course Project will use the Six Sigma DMAIC process.

Course Outcomes

The Course Project enables the student to meet the following Course Outcomes (COs):

· CO1: Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

· CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

Points

The entire Course Project is worth 600 points. Milestone 1 is worth 150 points of this total.

Due Date

Submit your completed NR392 Milestone 1 by Sunday, 11:59 p.m. MT, end of Week 1.

Requirements and Guidelines

o  Quality improvement is an important issue in professional nursing today. In Milestone 1, the student will define a nursing care issue (not a workforce issue such as staffing) from a current or former workplace or clinical setting that could be impacted by improved quality, and state the desired outcome of the improvement in quality. The student will then provide details about this issue, as well as explain the reason this issue was selected. Milestone 1 is due at the end of Week 1.

o  Download the required Milestone 1 Template (Links to an external site.).

o  Save it to your computer in Microsoft Word 2013 (or later) as a .docx file with the file name: Your Last Name NR392 Milestone 1.docx.

o  Carefully review the grading rubric criteria for Milestone 1.

o  Watch the video that provides a detailed overview of the requirements of Milestone 1.

· After you have developed your responses, type your responses directly in your saved Milestone 1 Template.

**Academic Integrity Reminder**

College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

Please see the grading criteria and rubrics on this page.

NOTE: Please use your browser’s File setting to save or print this page.

Rubric

NR392_Milestone1

NR392_Milestone1

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeNursing Care Issue and Outcome

Defines a nursing care issue from a current or former workplace (or clinical setting) that could be impacted by improved quality. States the desired outcome of the quality improvement process for the selected nursing care issue.

50.0 pts

Defines a nursing care issue from a current or former workplace (or clinical setting) that could be impacted by improved quality. States the desired outcome of the quality improvement process for the selected nursing care issue. Clarity and thoroughness are excellent.

44.0 pts

Defines a nursing care issue from a current or former workplace (or clinical setting) that could be impacted by improved quality. States the desired outcome. Clarity and thoroughness are good. Few revisions (if any) are needed.

40.0 pts

Defines a nursing care issue from a current or former workplace (or clinical setting) that could be impacted by improved quality. States desired outcome. Clarity and thoroughness are fair. Revisions are needed.

19.0 pts

Issue may be medical rather than nursing, OR issue poorly defined (lacks clarity and thoroughness). Outcome may not be stated. Issue is not approved.

0.0 pts

Does not define a nursing care issue.

50.0 pts

This criterion is linked to a Learning OutcomeDetails of the Issue

Explains selected nursing care issue, including why it is important to focus on this issue and how it impacts patients, staff, and/or facility.

50.0 pts

Explanation of selected nursing care issue is outstanding, including why it is important to focus on this issue and how it impacts patients, staff, and/or facility. Depth and detail are excellent.

44.0 pts

Explanation of selected nursing care issue is good, including why it is important to focus on this issue and how it impacts patients, staff, and/or facility. Depth and detail are good.

40.0 pts

Explanation of selected nursing care issue is fair. May or may not include why it is important OR how it impacts patients, staff, and/or facility. Depth and detail are fair.

19.0 pts

Description does not provide adequate explanation of details of the nursing care issue. May or may not include why it is important AND how it impacts patients, staff, and/or facility. Lacks depth and detail.

0.0 pts

No explanation of details is provided.

50.0 pts

This criterion is linked to a Learning OutcomeReason issue selected

Describes the reason the issue was selected.

50.0 pts

Description of reason the issue was selected is outstanding. Depth and detail are excellent.

44.0 pts

Description of reason the issue was selected is good. Depth and detail are good.

40.0 pts

Description of reason the issue was selected is fair. Depth and detail are fair.

19.0 pts

Description does not provide adequate explanation of reasons for selecting the nursing care issue. Lacks depth and detail.

0.0 pts

Does not provide the reason the issue was selected.

50.0 pts

Total Points: 150.0

Purpose

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Course Reflection Guidelines

Purpose

The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the NUR3165 course.

Course Outcomes

This assignment provides documentation of student ability to meet the following course outcomes:

– The student will be able to produce a complete research paper.

– The student will identify the research methods, sources and application in nursing practice.

Points

This assignment is worth a total of 100 points (10%).

Due Date

Submit your completed assignment under the Assignment tab by Sunday 11:59 p.m. EST of Week 15 as directed.

Requirements

1. The Course Reflection is worth 100 points (10%) and will be graded on quality of self-assessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.

2. Follow the directions and grading criteria closely. Any questions about your essay may be posted under the Q & A forum under the Discussions tab.

3. The length of the reflection is to be within three to six pages excluding title page and reference pages.

4. APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered):

Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).

a. Course Reflection

b. Conclusion

Preparing Your Reflection

The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for the BSN-prepared nurse. Reflect on the NUR3165 course readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:

1. “Explain the interrelationships among theory, practice, and research.

2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice.

3. Evaluate the credibility of sources of information, including but not limited to databases and Internet resources.

4. Acquire an understanding of the process for how nursing and related healthcare quality and safety measures are developed, validated, and endorsed.

Reference:

American Association of Colleges of Nursing [AACN]. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.

 Family Assessment

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Family Assessment Part II  View RubricDue Date: Feb 17, 2019 23:59:59       Max Points: 150  Details: Refer back to the interview and evaluation you conducted in the Topic 2 Family Health Assessment assignment. Identify the social determinates of health (SDOH) contributing to the family’s health status. In a 750-1,000-word paper, create a plan of action to incorporate health promotion strategies for this family. Include the following:

  1. Describe the SDOH that affect the family health status. What is the impact of these SDOH on the family? Discuss why these factors are prevalent for this family.
  2. Based on the information gathered through the family health assessment, recommend age-appropriate screenings for each family member. Provide support and rationale for your suggestions.
  3. Choose a health model to assist in creating a plan of action. Describe the model selected. Discuss the reasons why this health model is the best choice for this family. Provide rationale for your reasoning.
  4. Using the model, outline the steps for a family-centered health promotion. Include strategies for communication.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.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. Please refer to the directions in the Student Success Center.

Family Assessment Part II 1 Unsatisfactory 0.00%2 Less than Satisfactory 75.00%3 Satisfactory 79.00%4 Good 89.00%5 Excellent 100.00%80.0 %Content20.0 %SDOH Affecting Family and Family Health StatusSDOH affecting family health status, and the direct impact to the family, are not presented.SDOH affecting family health status are partially presented. SDOH listed are not relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are unclear. There are inaccuracies.Key SDOH affecting family health status are summarized. The SDOH identified are relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are generally discussed. More support or rationale is needed in some areas.The overall SDOH affecting family health status are accurately identified and described. The SDOH identified are relevant to the family. The direct impact to the family, and why the factors are prevalent to the family, are discussed. The SDOH directly affecting family health status are relevant, accurately identified and thoroughly described. The direct impact to the family, and why the factors are prevalent to the family, are discussed in detail. The discussion is well supported and illustrates insight into SDOH and their effect on family health status.20.0 %Age-Appropriate Screening RecommendationsAge-appropriate screenings are not presented.Screenings are presented for some family members. The screenings are not age appropriate. Screenings are not relevant to the information gathered through family health assessment. Screenings are presented for each family member. Screenings are generally age appropriate, but entirely not relevant based on the information gathered through family health assessment. More rationale and support is required.Screenings presented for each family member are age appropriate. Screenings are relevant and based on the information gathered through family health assessment. Some minor rationale or support is needed.Screenings presented for each family member are age appropriate and highly relevant. Screenings correlate to the information gathered through family health assessment. Strong rationale and support is presented.20.0 %Assessment of Health ModelA health model to assist in the creation of a plan of action is not presented. The model chosen is not a health model.A health model is selected to assist in creating a plan of action. The description of the model is incomplete. It is unclear why the chosen model is best for this family.A health model is selected and described. A summary of how the model will assist in creating a plan of action is presented. A general overview for why it is best for this family is provided. More rationale and support is required.A health model is selected and described. A discussion of how the model will assist in creating a plan of action is presented. Reasons for why it is best for this family are provided. Some rationale or support is needed.A health model is selected and thoroughly described. A detailed discussion of how the model will assist in creating a plan of action is presented. Reasons for why it is best for this family are clearly outlined. Strong rationale and support are provided to support reasoning.20.0 %Application of Health ModelFamily-centered health promotion using selected health model is omitted. Steps for a family-centered health promotion are partially presented. The health promotion is not based on the health model. Significant aspects are missing. There are major inaccuracies.The health model is used to create a general family-centered health promotion. The steps to achieve the desired outcome require more detail to illustrate a clear plan of action. A general plan for communication with the family is presented. More rationale and support is required.The health model is used to create a relevant family-centered health promotion. The steps to achieve the desired outcome are illustrated. Strategies for communication with the family are presented.The health model is used to create a relevant and viable family-centered health promotion. The steps to achieve the desired outcome are described in detail. Appropriate strategies for communication with the family are clearly presented. The health promotion is well-designed and demonstrates an ability to assimilate findings and appropriately apply theoretical knowledge to achieve desired outcomes.15.0 %Organization and Effectiveness 5.0 %Thesis Development and PurposePaper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.15.0 %Organization and Effectiveness 5.0 %Argument Logic and ConstructionStatement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.15.0 %Organization and Effectiveness 5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.5.0 %Format2.0 %Paper Format (use of appropriate style for the major and assignment)Template is not used appropriately or documentation format is rarely followed correctly.Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style.All format elements are correct. 3.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.100 %Total Weightage

immune disorders

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Respond on to  two different days who selected different immune disorders and/or factors than you, in the following ways:

Share insights on how the factor you selected impacts the pathophysiology of the immune disorder your colleague selected.

Expand on your colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.

Main Post

 

Maladaptive Responses to Immune Disorders

For this week’s discussion post, we will discuss the maladaptive and physiological responses of HIV and Lupus.  We will first discuss the pathophysiology of each and then further break the disorders down.  We will review how the gender factor might impact the pathophysiology of the disease.

Pathophysiology of HIV

Human Immunodeficiency Virus (HIV) is the viral infection that leads to Acquired Immune Deficiency Syndrome (AIDS).    HIV is a blood-borne pathogen.  Modes of transmission for HIV are IV drug abuse, blood product transfusion or transmission, maternal-child transmission, and both homosexual and heterosexual populations can be affected.  HIV seeks and destroys the CD-4+ Th cells.  CD-4+ cells are essential or the cytotoxic T cell and plasma cell development.  Because of the CD-4+ destruction, there is a suppressed immune response which leads to AIDS (Huether & McCance, 2017).

Maladaptive Response and the Female Factor

Maladaptive responses to HIV are anxiety, disturbed thought processes, imbalanced nutrition, infective coping, social isolation, this is just a few.  Women make up more than half the cases worldwide.  Approximately 50,000 new cases of HIV present each year in the United States, 25% of these new cases are from heterosexual relationships with two-thirds of that percentage being women, highest among black women (Huether & McCance, 2017).

Pathophysiology of Lupus

Autoantibodies target specific self-antigens known as the initiation phase.  Environmental factors, such as sunlight, may be the cause for these triggers or viral infections like Epstein-Barr. SLE has long been thought to have an active genetic link.  In an average individual, apoptotic cells self destruct but for individuals with systemic lupus erythema (SLE) effectively immunize themselves with bad cells from their tissue.  The body fights itself instead of excreting the bad cells.  Propagation is the second phase of SLE; this phase involves the inflammatory response and tissue damage and can affect the heart, kidneys, brain, skin, and joints.  Thirdly is the flare stage and includes a quicker and more vigorous immune response; this stage may provoke disease flares (Hammer & McPhee, 2019).

Maladaptive Response and the Female Factor

Maladaptive responses to SLE might be altered image issues, fatigue related to chronic inflammation, and impaired skin integrity related to skin rash.  Women are ten times more likely to develop SLE than men.  African Americans have the highest risk, followed by Hispanics, Asian Americans, and Native Americans.  The primary age to develop SLE is between 20-40 years old (the childbearing years) with the most prevalent age being around 30 (Lewis, Bucher, Heitkemper, & Harding, 2017).

References

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th  ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding  pathophysiology (6th ed.). St. Louis, MO: Mosby.

Lewis, S.L., Bucher, L., Heitkemper, M.M., & Harding, M.M.  (2017) Medical-surgical nuring assessment and management of clinical problems (10th ed.).  St. Louis, MO:  Elsevier

challenges with communication

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As nurses, we work with providers and healthcare team members whose native language is not English. In fact, some of you may have interviewed a non-native English speaker for your Course Project. This diversity may lead to challenges with communication and the nurse being “caught in the middle.”

Reflect on your newfound knowledge of transcultural nursing.

Share an example of miscommunication that occurred as a result of this diversity and whether an adverse outcome resulted.

Describe how the miscommunication could have been and will be prevented in the future.

health assessment histories

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Using the classroom resources or South University Online Library, research the tympanic membrane and the thyroid gland. In a Microsoft Word document of 4-5 pages formatted in APA style, address each of the following criteria.

  • Two focused health assessment histories
    • One assessment related to the tympanic membrane and the other focused on the thyroid gland.
    • The assessments can be hypothetical patients or patients you have had in the past (remember HIPAA if you are describing a previous patient).
  • A description of the normal and abnormal findings of the tympanic membrane.
  • Information on how to examine the thyroid gland using both the anterior and posterior methods.
  • A concise note in the subjective, objective, assessment (be sure to include the NANDA diagnosis as well as the medical diagnosis), and plan (SOAP) format with each patient’s encountered findings.
  • Information about laboratory/diagnostic tests used for screening clients with tympanic membrane or thyroid gland issues.
    • Include the expected normal results for each test.

On a separate references page, cite all sources using APA format. Please note that the title and reference pages should not be included in the total page count of your paper.

SOAP documentation

SOAP documentation is a problem-oriented technique whereby the nurse identifies and lists the patient’s health concerns. It is commonly used in primary health-care settings. Documentation is generally organized according to the following headings:

S = subjective data Example: What is the patient experiencing or feeling, how long has this been an issue, what is the frequency, intensity, duration, what makes it worse or better, any past history, family history, home monitoring results (BP, weight, glucose monitoring), etc.

O = objective data Example: Results of the physical exam, relevant vital signs, what the nurse observes, etc.

A = assessment Example: What is the nursing diagnosis or medical diagnosis (for existing problems), identification of the problem, etc. P = plan Example: What interventions are done during the visit, what is the follow-up, what medications have been prescribed or changed, what further testing or investigations are required, when will the patient be seen again, etc. Sample chart note: S: In for refills and review of diabetes. Home glucose monitoring – taking BG readings 3 times/week in morning only (fasting). Average BG 7-8. Has been trying to avoid sugary snacks but has just quit smoking so is finding this difficult. Walking 5 times/week for 30 minutes.

O: Blood work – A1C 7.2 (was 7.3), LDL 1.9, Ratio 3. BP 118/70. HR 72 regular. A: Diabetes (A1C not at target)

P: Provided with information on A1C, diabetes and targets. Provided with support and information related to nutrition and strategies to reduce sugary snacks. Reviewed blood glucose testing and will check postprandial sugars 2/week until next visit. 1. Encouraged to book eye exam 2. Due for foot exam next visit 3. Increase metformin to 1000mg bid 4. Repeat BW in 3/12 (annual inc nephropathy screening) – encouraged to check glucometer with bloodwork 5. RTC 3/12