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NURS 6630 Week 6 Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia

NURS 6630 Week 6 Assignment

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According to the National Alliance on Mental Illness, approximately 100,000 people experience psychosis in the United States each year (NAMI, 2016). In practice, clients may present with delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior, as well as other negative symptoms that can be disabling for these individuals. Not only are these symptoms one of the most challenging symptom clusters you will encounter, many are associated with other disorders such as depression, bipolar disorder, and disorders on the schizophrenia spectrum. As a psychiatric mental health nurse practitioner, you must understand the underlying neurobiology of these symptoms to select appropriate therapies and improve outcomes for clients.

This week, as you examine antipsychotic therapies, you explore the assessment and treatment of clients with psychosis and schizophrenia. You also consider ethical and legal implications of these therapies.

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Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia

Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.

Learning Objectives

Students will:

·         Assess client factors and history of developing personalized plans of antipsychotic therapy for clients

·         Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy

·         Evaluate the efficacy of treatment plans

·         Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

·         Chapter 4, “Psychosis and Schizophrenia”

·         Chapter 5, “Antipsychotic Agents”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

• amisulpride
• aripiprazole
• asenapine
• chlorpromazine
• clozapine
• flupenthixol
• fluphenazine
• haloperidol
• iloperidone
• loxapine
• lurasidone

• olanzapine
• paliperidone
• perphenazine
• quetiapine
• risperidone
• sulpiride
• thioridazine
• thiothixene
• trifluoperazine
• ziprasidone

Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649-659. doi:10.2165/00023210-200923080-00002

Note: Retrieved from Walden Library databases.

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.

Note: Retrieved from Walden Library databases.

Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from /orders/www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting

Required Media

Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: Author

Note: This case study will serve as the foundation for this week’s Assignment.

Optional Resources

Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5(3), 124-134. doi:10.3371/CSRP.5.3.2

Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728-738. doi:10.2146/ajhp130471

Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86(1), 107-121. doi:10.1007/s11126-014-9326-2

To prepare for this Assignment:

·         Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Finally: 1. Complete the decision tree (keep track of what you selected. come up with a rational reason why you chose it. Come up with patient specific rational reason behind not choosing the other two options not chosen).

2. Write paper addressing all section listed based on the decision tree.

Case Study: Pakistani Woman with Delusional Thought Processes:

BACKGROUND

The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her since she was 9 years old). She presents to your office today following a 21 day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month.

Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control” which resulted in his calling the police and her subsequent admission to an inpatient psych unit.

During today’s assessment, she appears quite calm, and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She tells you that she knows this because the television is telling her so.

She currently weighs 140 lbs, and is 5’ 5”

SUBJECTIVE

Client reports that her mood is “good.” She denies auditory/visual hallucinations, but believes that the television does talk to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards the PMHNP, but then calms down.

You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits.

Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described, above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.

The PMHNP administers the PANSS which reveals the following scores:

-40 for the positive symptoms scale

-20 for the negative symptom scale

-60 for general psychopathology scale

Diagnosis:

 Schizophrenia, paranoid type

Decisions Made and Outcomes (Needed to formulate the paper)

Choices for Decision 1: Select what the PMHNP should do:

1. Start Zyprexa 10 mg orally at BEDTIME
2. Start Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter
3.  Start Abilify 10 mg orally at BEDTIME

My decision: Start Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter

Outcome: RESULTS OF DECISION POINT ONE:

• Client returns to clinic in four weeks
• A decrease in PANSS score of 25% is noted at this visit
• Client seems to be tolerating medication
• Client’s husband has made sure she makes her appointments for injections (one thus far)
• Client has noted a 2 pound weight gain but it does not seem to be an important point for her
• Client complains of injection site pain telling the PMHNP that she has trouble siting for a few hours after the injections and doesn’t like having to walk around for such a long period of time

Choices for Decision 2: Select what the PMHNP should do:

1. Continue same decision made but instruct administering nurse to begin injections into the deltoid at this visit and moving forward
2. Discontinue Invega Sustenna and start Haldol Decanoate (haloperidol decanoate ) 50 mg IM q2weeks with oral Haldol 5 mg BID for the next 3 months
3. Continue Invega Sustenna. Begin injections into the deltoid and add on Abilify Maintena 300 mg intramuscular monthly with oral Abilify 10 mg in the MORNING for 2 weeks
4.  

My decision: Continue same decision made but instruct administering nurse to begin injections into the deltoid at this visit and moving forward

Outcome: RESULTS OF DECISION POINT TWO:

• Client returns to clinic in four weeks
• Client’s PANNS has reduced by a total of 50% from the initiation of Invega sustenna
• When questioned about injection site pain, client states it is much better in the arm
• Client’s weight has increased by an additional 2.5 pounds (total of 4.5 pounds in a 2 month period). She is somewhat bothered by the weight gain and is afraid that her husband does not like it. He is not present at this visit as she brought herself
• Client likes how she feels on the Invega Sustenna but is wondering if there is another drug like it that would not cause the weight gain

Choices for Decision 3: Decision Point Three Select what the PMHNP should do next:

1.  Continue with the Invega Sustenna. Counsel client on the fact that weight gain from Invega Sustenna is not as much as what other drugs with similar efficacy can cause. Make appointment with a dietician and an exercise physiologist. Follow up in one month
2. Discontinue Invega Sustenna and start Abilify Maintenna 400 mg IM monthly (after a few test doses of Abilify oral have been tried and tolerated) with overlapping oral abilify 10 mg orally in the MORNING
3. Continue Invega sustenna and add-on Qsymia for weight loss

Outcome: Guidance to Student

RESULT FROM CHOOSING TO CONTINUE INVEGA AND INCLUDE DIETICIAN AND AN EXERCISE PHYSIOLOGIST:

Guidance to Student

Weight gain can occur with Invega Sustenna. It is modest in nature and can be controlled with proper nutrition and exercise. It is always a good idea to try and control a client’s weight through consultation with a dietician and exercise physiologist (life coach) before switching to another agent when a product is showing efficacy for at least 6 months.

Abilify Maintena is a good option for someone who has good response to abilify oral. Remember that Abilify does not bind to the D2 receptor for a great period of time (such as Invega) and can be less affective in certain individuals. Also, remember that akathisia can be a possible side effect. Once an IM long acting medication is given, the effects of the drug (both efficacious and untoward effects) can be maintained for a long duration (up to a month or longer). Tolerability and efficacy should be established with oral medication first before administering the first injection. Also a disadvantage to Abilify Maintena is a 2-week overlap of oral therapy is required due to effective blood levels lagging behind the induction dose.

Qsymia is a weight loss medication that is a combination of Phenteramine and Topiramate. It is only indicated to treat obesity. This client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35, Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity). There are two things wrong with this therapy option. First, there are only a few occasions where add-on therapy to treat a side effect is acceptable and weight gain is not one of those scenarios. Secondly, Phenteramine has a lot of cardiovascular toxicities (such as elevated BP, HR, increased workload on the heart).

***Write on each decision. Make sure that in each decision choice that you explain why the other two decisions were not good choices. Use cited sources to validate points. Make sure that this paper has at least 7 References. Please use in-text citations for each section of each decision. Don’t forget the ethical considerations for this assignment. Make it a section by itself.***

***Also please make sure when looking at the ethical consideration for this assignment that you look at how Invega Sustenna and the Pakistani culture/ethnicity. What considerations does the drugs have with this ethnicity.***

DECISION CHOSEN 

Decision Point One

Start Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter

RESULTS OF DECISION POINT ONE

·  Client returns to clinic in four weeks

·  A decrease in PANSS score of 25% is noted at this visit

·  Client seems to be tolerating medication

·  Client’s husband has made sure she makes her appointments for injections (one thus far)

·  Client has noted a 2 pound weight gain but it does not seem to be an important point for her

·  Client complains of injection site pain telling the PMHNP that she has trouble siting for a few hours after the injections and doesn’t like having to walk around for such a long period of time

Decision Point Two

Continue same decision made but instruct administering nurse to begin injections into the deltoid at this visit and moving forward

RESULTS OF DECISION POINT TWO

·  Client returns to clinic in four weeks

·  Client’s PANNS has reduced by a total of 50% from the initiation of Invega sustenna

·  When questioned about injection site pain, client states it is much better in the arm

·  Client’s weight has increased by an additional 2.5 pounds (total of 4.5 pounds in a 2 month period). She is somewhat bothered by the weight gain and is afraid that her husband does not like it. He is not present at this visit as she brought herself

·  Client likes how she feels on the Invega Sustenna but is wondering if there is another drug like it that would not cause the weight gain

Decision Point Three

Continue with the Invega Sustenna. Counsel client on the fact that weight gain from Invega Sustenna is not as much as what other drugs with similar efficacy can cause. Make appointment with a dietician and an exercise physiologist. Follow up in one month

Guidance to Student

Weight gain can occur with Invega Sustenna. It is modest in nature and can be controlled with proper nutrition and exercise. It is always a good idea to try and control a client’s weight through consultation with a dietician and exercise physiologist (life coach) before switching to another agent when a product is showing efficacy for at least 6 months.

Abilify Maintena is a good option for someone who has good response to abilify oral. Remember that Abilify does not bind to the D2 receptor for a great period of time (such as Invega) and can be less affective in certain individuals. Also, remember that akathisia can be a possible side effect. Once an IM long acting medication is given, the effects of the drug (both efficacious and untoward effects) can be maintained for a long duration (up to a month or longer). Tolerability and efficacy should be established with oral medication first before administering the first injection. Also a disadvantage to Abilify Maintena is a 2-week overlap of oral therapy is required due to effective blood levels lagging behind the induction dose.

Qsymia is a weight loss medication that is a combination of Phenteramine and Topiramate. It is only indicated to treat obesity. This client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35, Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity). There are two things wrong with this therapy option. First, there are only a few occasions where add-on therapy to treat a side effect is acceptable and weight gain is not one of those scenarios. Secondly, Phenteramine has a lot of cardiovascular toxicities (such as elevated BP, HR, increased workload on the heart).

 

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NURS6052 Week 5 Course Project: Part 2—Literature Review

NURS6052 Week 5 Course Project

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Literature Review.Course Project: Part 2—Literature Review

This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.
The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.
To prepare:
· Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.
· Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.
· Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.
· Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.
To complete:
Write a 3- to 4-page literature review that includes the following:
· A synthesis of what the studies reveal about the current state of knowledge on the question that you developed
· Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.
· Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry
· Your literature review summary table with all references formatted in correct APA style
Note:  Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.

NURS 6002 Development Plan Part 5: Professional Development

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Development Plan Part 5: Professional Development.

The Assignment:

• Using the Academic Success and Professional Development Plan Template which you began to work on in Week 1 and have continued working on through this course, in Part 5, you will develop a curriculum vitae (CV)  based on your current education and professional background.
• Write a statement identifying your professional development goals.
• Write a statement proposing how you might align one or more of your professional development goals with the University’s emphasis on social change.

Social Change

Walden University defines positive social change as a deliberate process of creating and applying ideas, strategies, and actions to promote the worth, dignity, and development of individuals,  communities, organizations, institutions, cultures, and societies.  Positive social change results in the improvement of human and social conditions.
This definition of positive social change provides an intellectually comprehensive and socially constructive foundation for the programs,  research, professional activities, and products created by the Walden academic community.
In addition, Walden supports positive social change through the development of principled, knowledgeable, and ethical scholar-practitioners, who are and will become civic and professional role models by advancing the betterment of society.

NURS 6002: Foundations of Graduate Study Academic and Professional Success Plan

Prepared by:

Semiloore Akerele

This document is to be used for NURS 6002 Foundations of Graduate Study to complete Assessments 1-6. Just as importantly, the document serves to organize your thoughts about planning for your academic and professional success.

For specific instructions, see the weekly assessment details in the course, or ask your instructor for further guidance.

Week 1 | Part 1: My Academic and Professional Network

I have identified and secured the participation of the following academic (at least two) and professional (at least two) individuals and/or teams to form the basis of my network. This network will help me to clarify my vision for success and will help guide me now and in the future.

Directions: Complete the information below for each member of your network. For more than four entries repeat the items below with details of your additional network member(s) in the ‘ADDITIONAL NETWORK MEMBERS’ section.

NETWORK MEMBER 1

Name: Laurie Jenig BSN

Title:  Nursing Manager

Organization: Aurora Behavioral Health

Academic or Professional:  Professional

Why I selected this individual and/or team and how they will support my success in the MSN program and as a practicing nurse:

I selected this individual because of her leadership school. Despite the pressure at her workplace she is well coordinated and will never transfer aggression to her staff. She is a good listener and was resourceful to me during my BSN.  She thinks carefully and she has the ability to bounce idea back and forth with me

NETWORK MEMBER 2

Name: Bukola Adeyemi

Title: PMH-NP

Organization: Aurora Behavioral Health

Academic or Professional: Professional

Why I selected this individual and/or team and how they will support my success in the MSN program and as a practicing nurse:

Notes: I choose Bukola because she has been working with this organization for eight years. She started as a floor nurse in this organization, became a charge nurse and went back to school to be Psychiatry nurse practitioner. She gave me the push I need to go back to school. She brought some textbooks she used when she did hers.  She is well experienced in psychiatry nursing.

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NETWORK MEMBER 3

Name: Silfa Jones

Title: RN, BSN

Organization: Thorek Memorial Hospital

Academic or Professional:  Academics

Why I selected this individual and/or team and how they will support my success in the MSN program and as a practicing nurse:

Notes: I choose her because we were study mate for BSN. She currently in Walden too for psychiatry nursing.  We both attended meeting and seminars that benefitted our career the time. She is like a push to me and it makes all easy because I can get a physical person discuss my classes with.

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NETWORK MEMBER 4

Name: Melisa P MSN

Title: charge Nurse

Organization: Thorek Memorial Hospital

Academic or Professional:  Academic

Why I selected this individual and/or team and how they will support my success in the MSN program and as a practicing nurse:

Notes: I choose Melissa because she is a resourceful person.  She had her Bachelors in  psychology and the did her masters in Nursing. Apart from being a floor Nurse she just published her first articles in one of the local nursing Journal in Illinois. She is currently seeking for more information on what food will benefit schizophrenic patients. She is constantly in search of new knowledge.

ADDITIONAL NETWORK MEMBERS

Week 2 | Part 2: Academic Resources and Strategies

I have identified the following academic resources and/or strategies that can be applied to success in the nursing practice in general or my specialty in particular.

Directions: In the space below Identify and describe at least three academic resources or strategies that can be applied to the MSN program, and at least three professional resources that can be applied to success in the nursing practice in general or your specialty in particular. For each, explain how you intend to use these resources, and how they might benefit you academically and professionally.

Academic Resource/Strategy 1

Internet – The Internet is an incredible method to conduct investigations for an essential and auxiliary purpose. Since the arrangement of reference books are presently accessible on the web as opposed to printed frames; I currently manage everything on the internet. Pretty much everything is available on the web a large portion of them are accessible in a free source. I plan on using this insightful resource without confinements of my ability since the internet supports types of learning creation and information utilization that vary enormously from the epistemological assumptions of formal tutoring and mass guidance.

Academic Resource/Strategy 2

Tutoring and Help Rooms – I append myself to qualified and prepared peer tutors who will help me with mastering my course content and growing my potential for academic accomplishment. At the point when joined with customary participation of classes and recitations, visits to educators’ available time, utilization of departmental Help Rooms and development of peer study groups, mentoring serves as a proactive advance for guaranteeing that I scholastically succeed (Bradshaw & Hultquist, 2016). My technique is to search for my an academic director who will help me in recognizing different grounds assets that may be of help as I create study abilities and great work propensities, including Stress-busters.

Academic Resource/Strategy 3

Local Library – The use of my local library offers a full scope of assets and services to help all parts of my studies. Librarians will enable me to locate the best print and electronic assets and show me how to utilize bibliographic software just as different instruments that will allow me to design and manage data. My procedure will be straightforward since more often than not I go to classes, I will visit the library around evening time when I am finished with my classes.

Professional Resource/Strategy 1

ANA (American Nurses Association) – My plans for joining the association would enable me to finish the hover between clinical practice and the outside elements that impact nursing. Joining this association can too benefit me to increase clinical abilities and furthermore improve both my expert network and future profession prospects. There are such a substantial number of devices and resources for orderlies that I trust I will probably exploit as i advance in this field.

Professional Resource/Strategy 2

National Federation for Specialty Nursing Organizations (NFSNO) – This will enable me to create the vitality, stream of thoughts, and proactive work expected to keep up a sound calling that advocates for the necessities of its clients and medical attendants, and the trust of society (Sayles & Shelton, 2005).

Professional Resource/Strategy 3

ICN (The International Council of Nurses) – I plan to adequately look into the International Council of Nurses since ICN attempts to guarantee quality nursing care for all, stable wellbeing arrangements all-inclusive, the progression of nursing information, and the presence worldwide of a regarded nursing profession and a skilled and fulfilled nursing workforce. The association will enable me to create a consolidated stage for the definition and extent of training in my field.

ADDITIONAL RESOURCES/STRATEGIES

Week 3 | Part 3: Strategies to Promote Academic Integrity and Professional Ethics

I have analyzed the relationship between academic integrity and writing, as well as the relationship between professional practices and scholarly ethics. I have also identified strategies I intend to pursue to maintain integrity and ethics of my academic work while a student of the MSN program, as well as my professional work as a nurse throughout my career. The results of these efforts are shared below.

Directions: In the space below craft your analysis/writing sample, including Part 1 (The Connection Between Academic and Professional Integrity) and Part 2 (Strategies for Maintaining Integrity of Work).

Part 1: Writing Sample: The Connection Between Academic and Professional Integrity

In the space below write a 2- 3-paragraph analysis that includes the following:

· Explanation for the relationship between academic integrity and writing

· Explanation for the relationship between professional practices and scholarly ethics

· Cite at least 2 resources that support your arguments, being sure to use proper APA formatting.

· Use Grammarly and SafeAssign to improve the product.

· Explain how Grammarly, Safe Assign, and paraphrasing contributes to academic integrity

Academic integrity is defined as the frequencies of being honest and it is being displayed in all academic aspects. Violation of academic integrity makes it hard for students to access suitable knowledge which is important in having a successful academic outcome. The most common factors associated with academic dishonesty are related to issues such as plagiarism and academic forgery. Plagiarism and academic forgery are considered to be unethical in the academic environment. In a nursing career, there is a connection between academic integrity and writing. In academic ethics, any person is capable of displaying moral ethics on the written work through recognizing the work of other scholars. Integrity is considered to be the most important aspect of writing since it is demonstrating some important aspects of academic intellectuality (Cock, 2016). For the purposes of ensuring that there is academic integrity while writing a project or essay, it is always important to avoid involvement in plagiarism to help in the presentation of authentic and original work. When the work of other scholars is used, it is crucial to acknowledge them through referencing.

The relationship between professional practices and scholarly ethics

In nursing practices, it is always important to adopt the practice of embracing scholarly ethics to ensure that there is involvement in honesty practices. In nursing practice, ethical standards are high values and are considered to be the moral integrity which forms an important element towards delivering quality healthcare services to the patients (Milton, 2015). Evidence-based practice is important in ensuring that there is a professional practice within the field of nursing practice and it is usually based on the scholarly articles.it is, therefore, a requirement that nurses put more focus on the scholarly articles which are easily referable. A constructive link between professionalism and the academic ethics is helping in the creation of ethical workplace for nurses hence assisting in the development of trust from the patients to ensure that there is a delivery of quality care to the clients. There is also the existence of the code of ethics which guides nursing practices and are based on the scholarly articles written by specific authors or organizations. It is, therefore, a requirement for nurses to observe the code of ethics to help in improving the quality of care being provided to the patients.

How Grammarly, safe assign and paraphrasing are contributing to the academic integrity

Grammarly, safe assign and paraphrasing are playing an essential role in enhancing the ability of the students. Grammarly allows students to proofread the grammatical errors, spelling check, and punctuation. It is also possible to check on plagiarism which also provides the chances of making a correction to the mistakes made and citing appropriate sources. Correspondingly, Safe Assign and Turnitin are applications which have been developed to help in the detection of plagiarism. These applications are important in helping the students or writers to gather more knowledge regarding the appropriate methods of using academic resources and methods of citing them during writing (Milton, 2015).

PART 2: Strategies for Maintaining Integrity of Work

Expand on your thoughts from Part 1 by:

Identifying and describing strategies you intend to pursue to maintain integrity and ethics of your 1) academic work while a student of the MSN program, and 2) professional work as a nurse throughout your career. Include a review of resources and approaches you propose to use as a student and a professional.

Based on my academic work, I have the intention of upholding academic integrity by practicing suitable paraphrasing while writing as well as citing scholarly articles. Grammarly will be continuously used to ensure that the standards of the grammar are met. I am also aiming at making a continuous consultation with my instructor for guidance more so in the areas where I feel to be not well conversant with. The assigned academic work will be submitted on a timely basis and will observe time to make sure that I sit in an area which is safe and appropriate which might help in reducing the chances of looking at the answers of the fellow student. Private properties such as cell phones and bags will be placed far from the exam room to avoid any temptation of cheating. The safe assign and Turnitin app will be relied on to help in correcting the plagiarism issues and making corrections prior to the submission of my work. Being a nurse, I will deeply rely on evidence-based care as well as the standard code of ethics to help in the delivery of quality healthcare services. I will always be honest, show empathy, and be trustworthy to the patients.

Week 4 | Part 4: Research Analysis

I have identified one topic of interest for further study. I have researched and identified one peer-reviewed research article focused on this topic and have analyzed this article. The results of these efforts are shared below.

Directions: Complete Step 1 by using the table and subsequent space below identify and analyze the research article you have selected. Complete Step 2 by summarizing in 2-3 paragraphs the results of your analysis using the space identified.

Step 1: Research Analysis

The scholarly article which is peer-reviewed which I selected is “Associations of age at cannabis first use and later substance abuse with mental health and depression in young men.”

The authors associated between age at cannabis first use and the recurrence of cannabis usage utilizing a “Cox proportional hazard technique.” Relationship with other unlawful medication use, liquor reliance, nicotine reliance, psychological well-being, and depression was examined utilizing direct relapses and logistics relapses. In this manner, the expert practice utilization of the speculations/ideas displayed in the article is the Cox proportional hazard show that they explored the relationship between the survival time of participants and at least one indicator factors.

Complete the table below

Step 2: Summary of Analysis

Craft a summary (2-3 paragraph) below that includes the following:

· Describe your approach to identifying and analyzing peer-reviewed research

· Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research

· Identify at least one resource you intend to use in the future to find peer-reviewed research

I would recommend this article for professional use because it is peer reviewed since it is bound to be accurately consistent and achieve sensible outcomes.

To find peer-reviewed sources I previously checked my library database. The library database had a choice to refine my search and show just insightful articles. Two methodologies I would use to look for a peer-reviewed article are “phrase search” – this is the use of double statements around an expression to cut the words together for example, “sustainable advancement.” Truncation – cutting a word and finding the substitute endings of the word, for example, create* finds create, creates, creative, or creating.

One resource I expect to use later on to discover peer-reviewed study is peer-reviewed journals because these articles are composed by professionals and are audited by a few different experts in the field before the report is distributed in the journal to guarantee the article’s quality.

Reference

Henchoz, Y., N’Goran, A. A., Baggio, S., Deline, S., Studer, J., & Gmel, G. (2016). Associations of age at cannabis first use and later substance abuse with mental health and depression in young men. Journal of Substance Use, 21(1), 85-91.Retrieved from: /orders/www.tandfonline.com/doi/ref/10.3109/14659891.2014.966342?scroll=top

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.

Week 6 | Part 6: Finalizing the Plan

I have considered various options for my nursing specialty, including a close look at my selected (or currently preferred) specialty and second-preferred specialty. I have also developed a justification of my selected (or preferred) specialty. Lastly, I have examined one professional organization related to my selected or preferred specialty and considered how I can become a member of this organization.

The results of my efforts are below.

Directions: Complete Step 1 by writing 2-3 paragraphs in the space below comparing the nursing specialty you have selected – or the one you prefer if your choice is still under consideration – to your second preference. Identify each specialty and describe the focus and the role that graduates are prepared for. Identify any other differentiators you feel are significant, especially those that helped or may help you reach a decision.

Complete Step 2 by writing a paragraph identifying and justifying your reasons for choosing your MSN specialization. Be sure to incorporate any feedback you received from colleagues in this week’s Discussion Forum.

Complete Step 3 by examining and identifying one professional organization related to your selected or preferred specialty. Explain how you can become a member of this organization.

Step 1: Comparison of Nursing Specialties

Use the space below to write 2-3 paragraphs comparing the nursing specialty you have selected – or the one you prefer if your choice is still under consideration – to your second preference. Identify each specialty and describe the focus and the role that graduates are prepared for. Identify any other differentiators you feel are significant, especially those that helped or may help you reach a decision.

Step 2: Justification of Nursing Specialty

Use the space below to write a paragraph identifying and justifying your reasons for choosing your MSN specialization. Be sure to incorporate any feedback you received from colleagues in this week’s Discussion Forum.

Step 3: Professional Organizations

Use the space below to identify and examine one professional organization related to your selected or preferred specialty. Explain how you can become a member of this organization.

– END –

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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• Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

• Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

• APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

• Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

• LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

• Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

• Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. NURS 6002 Development Plan Part 5: Professional Development

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NURS 6521 FINAL EXAM (3 VERSIONS) & NURS 6521 MIDTERM EXAM (3 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 600 Q & A

NURS 6521 FINAL EXAM (3 VERSIONS) & NURS 6521 MIDTERM EXAM (3 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 600 Q & A.   NURS 6521 FINAL EXAM (3 VERSIONS) & NURS 6521 MIDTERM EXAM (3 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 600 Q & A)

NURS 6521 Final Exam / NURS6521 Final Exam (Latest): Advanced Pharmacology: Walden University
Walden NURS 6521 Final Exam / Walden NURS6521 Final Exam (Latest): Advanced Pharmacology
· Question 1

After 6 months of unsuccessfully   trying to conceive, a 31-year-old woman and her husband have sought a   referral to a fertility specialist in order to explore their options. A nurse   at the clinic should recognize that the woman may benefit from
· Question 2

Which of the following would the   nurse include in a teaching plan about the signs and symptoms of   thrombophlebitis and thromboembolism that should be reported by a patient   taking estrogen?
· Question 3

A nurse works at a weight   management clinic. To which of the following overweight patients could the   nurse safely administer dextroamphetamine?

· Question 4

A 71-year-old man has just been   prescribed finasteride (Proscar). Which of the following complaints by this   patient most likely indicated a need for this drug?

· Question 5

A 38-year-old pregnant patient   admits to the nurse that she is an alcoholic and has been consuming alcohol   during her pregnancy. The nurse knows that using alcohol during pregnancy may   result in a child who presents with

· Question 6

A nurse practitioner orders 150 mg   of oral fluconazole for a patient with vulvovaginal candidiasis. The patient   should expect to take medication

· Question 7

An oncology nurse is reviewing the   pathophysiology of cancer and is discussing with a colleague the factors that   contribute to the success or failure of a patient’s chemotherapy. Which of   the following cancerous cells is most susceptible to the effects of   chemotherapeutic drugs?

· Question 8

A middle-aged patient has received   a diagnosis of GI stromal tumor following an extensive diagnostic workup.   Imatinib has been recommended as a component of the patient’s drug regimen.   What patient education should the nurse provide to this patient?

· Question 9

A 12-year-old boy is being   discharged from the hospital after major surgery. The boy will be taking two   medications at home for an extended period. The nurse who is discharging the   patient should provide medication teaching specifically to

· Question 10

A patient has been admitted to the   critical care unit with a diagnosis of peritonitis that has necessitated   treatment with gentamicin. As a result, the care team should be cautious when   concurrently administering other medications that may cause

· Question 11

A 39-year-old woman is receiving   doxorubicin for the treatment of cancer. After each treatment, the patient   has acute nausea and vomiting accompanied by a slightly increased heart rate.   The nurse will advise her to

· Question 12

A nurse is caring for a patient   with cancer who has been prescribed dronabinol (Marinol) to help reduce   nausea and vomiting from chemotherapy. The nurse will inform the patient that   he or she is taking an oral form of

· Question 13

A 46-year-old man is receiving a   quinupristindalfopristin IV infusion for a life-threatening infection. Which   of the following would be most important for the nurse to monitor?

· Question 14

A woman is receiving prolonged   drug therapy during her complicated pregnancy, and it may pose a risk to both   the mother and the fetus. The primary care physician has made dosage   adjustments to minimize adverse effects and prevent toxicity. The nurse   should make sure

· Question 15

Alprostadil (Caverject), a drug   used to treat erectile dysfunction, has been prescribed to a 42-year-old   patient. When providing education to the patient and his wife, the nurse   should inform the wife about which of the following adverse effects?

· Question 16

A 36-year-old patient comes to the   clinic and tells the nurse that she suspects that she is pregnant. During the   initial assessment, the nurse learns that the patient is currently taking   medications for diabetes, hypertension, and a seizure disorder. The nurse   would be most concerned about which of the following medications?

· Question 17

A male patient with a medical   background tells the nurse that he is not satisfied with the oral synthetic   testosterone that has been prescribed for him and he would like to try a   natural form of oral testosterone. Which of the following would be an   appropriate response by the nurse?

· Question 18

A male patient is trying to decide   if he should use finasteride (Proscar) to treat benign prostatic hypertrophy   (BPH). When providing information about the drug, the nurse will include   which of the following as a risk associated with finasteride therapy?

· Question 19

A 2-year-old child is diagnosed   with a minor ailment and is to be administered medications at home for 2   weeks. The child lives with his mother, grandmother, and four other children   between the ages of 14 months and 7 years. The home health nurse is asked to   assess the home environment to determine if it is appropriate for the child   to take his medication at home. Which of the following will have the greatest   impact on the nurse’s assessment?

· Question 20

A 22-year-old woman has given   birth to an infant who exhibits the signs and symptoms of maternal cocaine   use during pregnancy. These signs and symptoms are a result of what   pathophysiological effect of opioid use during pregnancy?

· Question 21

A 62-year-old patient taking   tamoxifen exhibits increased bone and tumor pain along with a local disease   flare. The nurse interprets this as an indication of which of the following?

· Question 22

A female patient is prescribed   oprelvekin therapy to treat thrombocytopenia. Which of the following should   the nurse continuously monitor to determine the efficacy and duration of the   oprelvekin therapy?

NURS 6521 WEEK 3 ASSIGNMENT: Asthma And Stepwise Management

WEEK 3 ASSIGNMENT: Asthma And Stepwise Management

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Asthma And Stepwise Management.

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.
• Please review the rubric for this assignment..

NURS 6003 Week 8 Discussion: Strategies for Academic Portfolios

NURS 6003 Week 8 Discussion

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Discussion: Strategies For Academic Portfolios. In the realm of marketing, a successful branding strategy is one of the most important contributors to organizational success. A solid branding strategy can help add visibility and credibility to a company’s products.

Similarly, nurse-scholars can build a personal brand to add visibility and credibility to their work. You can begin building your brand by developing and maintaining an academic portfolio. Such an activity can help share the results of your efforts and contribute to your success. This Module’s Discussion asks you to consider and share strategies for building your portfolio.
To Prepare:

• Reflect on strategies that you can pursue in developing portfolios or portfolio elements that focus on academic achievements.
• Review one or more samples from your own research of resources focused on portfolio development.

By Day 3 of Week 8

Post an explanation of at least two strategies for including academic activities and accomplishments into your professional development goals. Then, explain how those goals may align with the University’s emphasis on social change. Be specific and provide examples.

By Day 6 of Week 8

Respond to at least two of your colleagues’ posts by offering additional ideas regarding academic achievements to include or offering alternative ways of presenting the current achievements.
APA 7 formatting at least 3 references including DOI number,  and two paragraphs each.
Discussion for reply one (Eliz)
Week 8 Main Discussion Post
Besides the day to day bustle of nursing life, it is important to have vision of future plans.  These plans, when clearly laid out, create a map to success.  Achieving the “stops” on the way along the map to success, are opportunities for growth that, when accomplished, should be added to our portfolio.  This portfolio will be used to help leverage our position among other qualified individuals and set us apart when vying for employment opportunities, as well as help us excel in our practice.
Along with advancing my education in this program, one of the ways I have contributed to my academic portfolio is by becoming certified in my area of nursing practice.  Certified nurses have shown to be a benefit to patients, their families, and employers (Certification Benefits Patients, Employers and Nurses, n.d.).  By achieving certified status, it has been shown that certified nurses make decisions with more confidence and gain more satisfaction in their profession (Certification Benefits Patients, Employers and Nurses, n.d.).  I have to agree with these statements as I have seen a tremendous benefit in my practice since achieving certification, as well as a respect from colleagues that I hadn’t been as aware of previously.
Another strategy that I plan to add to my portfolio is working with nursing education on RN competencies.  I have had the opportunity to participate in annual nursing competencies at my facility on mechanical circulatory support, since I am the content expert for the facility.  I really enjoy teaching and find that I am also able to learn more myself by coming up with new and innovative ways to present the material.  Focusing on continuing education and becoming an expert has been shown to expand professional development in nursing exponentially (Sadler, 2018).  Although teaching is not ultimately what I want to do, it is nice to have the opportunity to participate and contribute to the continuing education of my colleagues.
Walden University’s vision of social change is to change practice on a global scale (Social Change, 2020).  I believe both of these initiatives will help contribute to this mission as they will allow for the advancement of practice in nursing.  Having an advanced certification and sharing that knowledge with colleagues can only benefit patient care and increase outcomes in the long run.  I look forward to being able to continue to contribute to this change by obtaining my advanced degree and being able to expand my scope of practice as well.

NURS 6003 Week 8 Discussion: Strategies for Academic Portfolios Main Posting RUBRIC 

Excellent 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Good 40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

Fair 35 (35%) – 39 (39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Poor 0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness

—

Excellent 10 (10%) – 10 (10%)

Posts main post by day 3.

Good 0 (0%) – 0 (0%)

Fair 0 (0%) – 0 (0%)

Poor 0 (0%) – 0 (0%)

Does not post by day 3.

First Response

—

Excellent 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

Good 15 (15%) – 16 (16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Fair 13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Poor 0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response

—

Excellent 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

Good 14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Fair 12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

Poor 0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation

—

Excellent 5 (5%) – 5 (5%)

Meets requirements for participation by posting on three different days.

Good 0 (0%) – 0 (0%)

Fair 0 (0%) – 0 (0%)

Poor 0 (0%) – 0 (0%)

Does not meet requirements for participation by posting on 3 different days.

NURS 6512 Week 4 Assignment 1: Differential Diagnosis For Skin Conditions

NURS 6512 Week 4 Assignment 1: Differential Diagnosis For Skin Conditions

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Assignment 1: Lab Assignment: Differential Diagnosis For Skin Conditions. Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

                                                To Prepare
Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.
Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
Consider which of the conditions is most likely to be the correct diagnosis, and why.
Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.
Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.
Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.
The Lab Assignment
Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style.
Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
Use clinical terminologies to explain the physical characteristics featured in the graphic.
Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose.
Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources.

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NURS 6501 week 1 Module 1 Adv. Pathophysiology Assignment: Case Study Analysis

NURS 6501 week 1 Module 1 Adv. Pathophysiology Assignment: Case Study Analysis

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A Patho Wk1-2Assign

A Patho Wk1-2Assign. Adv. Pathophysiology 6501 Module 1 Assignment: Case Study Analysis

WEEK #2 TOPIC

Posted on: Sunday, March 1, 2020 12:00:00 AM EST
WEEK #2 –- CASE STUDY ANALYSIS
Scenario 1: A 49-year-old patient with rheumatoid arthritis comes into the clinic with a chief complaint of a fever. Patient’s current medications include atorvastatin 40 mg at night, methotrexate 10 mg po every Friday morning and prednisone 5 mg po qam. He states that he has had a fever up to 101 degrees F for about a week and admits to chills and sweats. He says he has had more fatiguethan usual and reports some chest pain associated with coughing. He admits to having occasional episodes of hemoptysis. He works as a grain inspector at a large farm cooperative. After extensive work-up, the patient was diagnosed with Invasive aspergillosis.

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.
Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans. In this Assignment, you examine a case study and analyze the symptoms presented. You identify a cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.
To prepare:
By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)
Develop a 1- to 2-page case study analysis in which you:
· Explain why you think the patient presented the symptoms described.
· Identify the genes that may be associated with the development of the disease.
· Explain the process of immunosuppression and the effect it has on body systems.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, citations and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at /orders/academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

RUBRIC

Readings
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
·  Chapter 1: Cellular Biology; Summary Review
·  Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents(pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
· Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases,
· Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
· Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
· Chapter 7: Innate Immunity: Inflammation and Wound Healing
· Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
· Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
· Chapter 10: Infection (stop at Infectious parasites and protozoans); (start at HIV); Summary Review
· Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
· Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
· Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review
Note: You previously read these chapters in Week 1 and you are encouraged to review once again for this week.

Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from /orders/www.ncbi.nlm.nih.gov/books/NBK513315/

Nurs 6600 Assignment 1: Practicum Professional Experience Plan (PPEP)

Nurs 6600 Assignment 1: Practicum Professional Experience Plan (PPEP)

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 Refer to the instructions in Week 1 to create practicum professional development objectives that meet the requirements for this course.
Objective 1: Analyze three common barriers to effective communication, then compare and contrast two effective resolution strategies as defined in evidence-based literature.
Objective 2: Contrast units that have success with retention and recruitment of novice nursing staff and those who have high turnover; identifying factors of influence and comparing to peer-reviewed literature.
Assignment 1:
Practicum Professional Experience Plan (PPEP)Success comes from knowing that you did your best to become the best that you are capable of becoming.
— John Wooden, My Personal Best: Life Lessons from an All-American JourneyAs you considered in this week’s Discussion, your experiences in the practicum can provide a vital avenue for professional development.For this Assignment, you develop a Practicum Professional Experience Plan (PPEP) to outline how your involvement in the practicum will contribute to your growth as a professional and allow you to hone your specialization knowledge and skills. The PPEP consists of two or three objectives related to professional development that you will address during your Practicum Experience.

Note: In the practicum manual these are referred to as your individualized learning objectives.

To prepare:

As necessary, review the information related to developing objectives provided in this week’s Learning Resources.Revisit the objective(s) you crafted for this week’s Discussion, and reflect on the ideas exchanged in this forum. Refine the objective(s) as needed, making sure they reflect the higher-order domains of Bloom’s Taxonomy (i.e., Application level and above).

Note: You will be developing two to three professional development objectives for this assignment.Think more deeply about areas for which you would like to gain application-level experience and/or continued professional growth. How can your experiences in the practicum help you achieve these aims?

Discuss your professional aims and your proposed practicum professional development objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.

Download and save the Practicum Professional Experience Plan Form provided in this week’s Learning Resources.
To complete your Practicum Professional Experience Plan:Record the required information in each area of the Professional Practicum Experience Plan, including two or three objectives you will use to facilitate your professional development during the practicum.
Objective 3: Develop and prioritize a one-month productivity expense report that will be used to budget upcoming expenditures and incorporate a balanced unit financial statement in accordance with previous budgets and evidence-based literature.

Resources
Cipriano, P. F., & Murphy, J. (2011). The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 286–289.
Note: Retrieved from the Walden Library databases. “Technology tools will continue to revolutionize how we plan, deliver, document, review, evaluate, and derive the evidence about care” (p. 289). This article examines how nurses can use information technology to transform nursing and redesign the health care system. It focuses on the use of technology to promote quality and notes that technology can also be used to address challenges in education, research, leadership, and policy.McKimm, J., & Swanwick, T. (2009). Setting learning objectives. British Journal of Hospital Medicine, 70(7), 406–409.
Note: Retrieved from the Walden Library databases. This article clarifies the terminology associated with learning objectives and explains how learning objectives relate to professional development and the transformation from novice to expert. It also introduces common pitfalls when setting learning objectives and provides suggestions for avoiding them.Murphy, J. (2011). The nursing informatics workforce: Who are they and what do they do? Nursing Economic$, 29(3), 150–153.
Note: Retrieved from the Walden Library databases. The author examines the nursing informatics workforce, explaining that professionals in this well-established specialty area can play an integral role in transforming health care.Sørensen, E. E., Delmar, C., & Pedersen, B. D. (2011). Leading nurses in dire straits: Head nurses’ navigation between nursing and leadership roles. Journal of Nursing Management, 19(4), 421–430.
Note: Retrieved from the Walden Library databases. “Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity” (p. 421). In this article, the authors examine how individuals in key professional roles negotiate between and apply nursing and leadership skills.

NURS6521 Week 6 Quiz 

NURS6521 Week 6 Quiz 

Walden NURS6521 Week 6 Quiz 2017. Question 1 A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain
B) fatigue
C) breathing difficulties
D) heart palpitations
Question 2 A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?
A) Green beans
B) Shrimp
C) Eggs
D) Milk
Question 3 A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?
A) Small doses of long-acting insulin administered four to five times daily
B) Doses of basal insulin twice daily with regular insulin before each meal
C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening
D) Divided doses of intermediate-acting insulin every 2 hours, around the clock
Question 4 A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?
A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D
Question 5 A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to
A) crush the tablet before swallowing
B) swallow the tablet whole
C) swallow the tablet with milk or food
D) avoid drinking milk for 3 hours after swallowing the tablet
Question 6 A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?
A) Avoid high-fat foods
B) Drink plenty of water every day
C) Take the tablets before bedtime
D) Avoid red meat
Question 7 A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize
A) the need to rotate the injection site of the drug
B) the need to avoid crushing the tablet
C) the need to place the tablet under the tongue
D) the need to use only the thigh muscle for the drug injection site
Question 8 A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?
A) Hypothermia
B) Hypotension
C) Renal dysfunction
D) Bleeding
Question 9 A nurse will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months?
A) Liver function tests
B) Blood sugar levels
C) Blood pressure
D) Body temperature
Question 10 Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)?
A) Do not walk or drive after taking the drug
B) Discontinue the use of alcohol
C) Learn to self-administer the drug
D) Take a laxative when needed
Question 11 A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?
A) Decreased libido
B) Increased blood glucose
C) Dry eyes
D) Jittery feeling
Question 12 A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed.Before the drug therapy is started, the nurse will assess for which of the following?
A) History of taking anticoagulant drugs
B) Allergy to seafood
C) Hirsutism
D) The patient’s age
Question 13 A nurse is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the nurse suggest if the goal is to promote absorption of the regular insulin?
A) Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle
B) Select one injection site for regular insulin injections and use it exclusively
C) Administer the medication 30 to 60 minutes after a meal
D) Select one anatomic area for regular insulin injections and then use serial locations within that area.
Question 14 A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following?
A) Prothrombin time and partial thromboplastin time
B) Urine specific gravity
C) Alanine aminotransferase and total bilirubin levels
D) Follicle-stimulating hormone levels
Question 15 The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout.What is the primary purpose of this drug?
A) To balance urate concentration and prevent gout attacks
B) To promote the remodeling of damaged synovium
C) To potentiate the metabolism of dietary purines
D) To achieve pain relief in joints affected by gout
Question 16 A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?
A) Dietary habits
B) Work environment
C) Typical daily fluid intake
D) Ethnicity
Question 17 During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?
A) The patient’s environment
B) The patient’s diet
C) The condition of the patient’s skin
D) The condition of the patient’s nasal passages
Question 18 A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?
A) Hepatic function
B) Cardiac function
C) Respiratory function
D) Renal function
Question 19 Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?
A) The resident has not eaten breakfast because of a recent loss of appetite
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm
C) The resident had a fall during the night while transferring from her bed to her bathroom
D) The resident received her annual influenza vaccination the previous day
Question 20 To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should
A) administer calcium supplements
B) position the patient in the side-lying position
C) administer carbohydrates
D) monitor for nausea and vomiting
Question 21 A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to report which of the following immediately?
A) Vertigo
B) Intolerance to cold
C) Loss of appetite
D) Epigastric distress
Question 22 A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s
A) blood pressure
B) potassium level
C) use of alcohol
D) use of salt in his diet
Question 23 A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?
A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”
B) “We’ll need to closely monitor your blood sugar levels for the next week.”
C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”
D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”
Question 24 A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?
A) Eat a high-protein diet
B) Decrease the dosage if any adverse effect is experienced
C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight
D) Have a complete blood cell count done weekly
Question 25 A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?
A) Risk for Injury related to CNS depressant effects
B) Diarrhea related to anticholinergic effects
C) Altered Nutrition, Less than Body Requirements, related to appetite suppression
D) Impaired Swallowing related to increased muscle tone
Question 26 A 70-year-old woman who is on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. In the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to
A) anemia
B) peptic ulcer disease or gastritis
C) interstitial nephritis
D) constipation
Question 27 A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?
A) Bronchoconstriction
B) Hepatotoxicity
C) Aplastic anemia
D) Agranulocytosis
Question 28 A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to
A) avoid aggravating the gastrointestinal tract
B) ensure quick distribution of the drug
C) prevent the risk of infection or bleeding
D) minimize the risk of depressed bone marrow function
Question 29 A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of
A) daily, outpatient intravenous therapy
B) daily, oral administration
C) weekly subcutaneous injections
D) weekly administration of an enteric coated tablet
Question 30 A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically?
A) Antidiuretic hormone (ADH) levels
B) Height
C) Dehydration
D) Water retention