Advanced Pathophysiology

Advanced Pathophysiology

Advanced Pathophysiology

Parts  1,2 and 3  have the same questions, however, you must answer with references and different writing always addressing them objectively, that is as if you were different students. Similar responses in wording or references will not be accepted.

APA format

1) Minimum 6 pages  (No word count per page)- Follow the 3 x 3 rule: minimum of three paragraphs per page

You must strictly comply with the number of paragraphs requested per page

.

           Part 1: minimum  2 pages

           Part 2: minimum   2 pages

           Part 3: minimum   2 pages

Submit 1 document per part

2)¨******APA norms

All paragraphs must be narrative and cited in the text- each paragraph

         Bulleted responses are not accepted

         Don’t write in the first person 

Don’t copy and paste the questions.

Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed.

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc

__________________________________________________________________________________

Parts  1, 2 and 3 have the same questions, however, you must answer with references and different writing always addressing them objectively, that is as if you were different students. Similar responses in wording or references will not be accepted.

Part 1: Advanced Pathophysiology

Briefly answer the questions in a couple of lines. Do not include unsolicited information

Topic:  Endocrine System

1- What are hormones and its general characteristics?

2- Regulation of Hormone release based on negative feedback: post an example.

3- Explain up and down regulation of hormone receptors.

4- How does the Pituitary-Hypothalamic axis work?

5- Mention the Hormones released from Anterior and Posterior Pituitary gland.

6- Functions of Pineal Gland.

7- Complete for each of these glandular organs which are the hormones produced and which are the functions of these hormones.

Thyroid

Parathyroid

Pancreas (endocrine activity)

Adrenal (from cortex and medulla)

8- Content of Slide 55 in PPT repost here (forget this question)

9- What is…? Syndrome of inappropriate antidiuretic hormone (SIADH) secretion vs Diabetes Insipidus (types)

10- What is Hypopituitarism and Hyperpituitarism?

11- What happens with Hypersecretion of GH?

12- Thyroid disorders: Primary vs secondary. Thyrotoxicosis symptoms. Graves Disease: mechanism of production and symptoms. Hypothyroidism etiology and symptoms.

13- Hyperparathyroidism: which is primary, secondary and tertiary?

14- Cushing Syndrome vs Cushing Disease.

15- What is Addison’s Disease and symptoms?

16- Pheochromocytoma. Hormone in excess and symptoms.

17- Obesity: concept. Visceral vs Peripheral

18- Diabetes Type 1 vs 2: mechanism of production (pathophysiology) What is A1C?

19- Clinical manifestations of DM Type 1 and DM Type 2?

20- What is Gestational Diabetes and why it occurs?

21- Which are the acute complications of Diabetes?

22- From chronic complications of diabetes which are Macro and Microvascular?

23- Why patients with type 2 Diabetes may not suffer from Ketoacidosis?

Part 2: Advanced Pathophysiology

Briefly answer the questions in a couple of lines. Do not include unsolicited information

Topic:  Endocrine System

1- What are hormones and its general characteristics?

2- Regulation of Hormone release based on negative feedback: post an example.

3- Explain up and down regulation of hormone receptors.

4- How does the Pituitary-Hypothalamic axis work?

5- Mention the Hormones released from Anterior and Posterior Pituitary gland.

6- Functions of Pineal Gland.

7- Complete for each of these glandular organs which are the hormones produced and which are the functions of these hormones.

Thyroid

Parathyroid

Pancreas (endocrine activity)

Adrenal (from cortex and medulla)

8- Content of Slide 55 in PPT repost here (forget this question)

9- What is…? Syndrome of inappropriate antidiuretic hormone (SIADH) secretion vs Diabetes Insipidus (types)

10- What is Hypopituitarism and Hyperpituitarism?

11- What happens with Hypersecretion of GH?

12- Thyroid disorders: Primary vs secondary. Thyrotoxicosis symptoms. Graves Disease: mechanism of production and symptoms. Hypothyroidism etiology and symptoms.

13- Hyperparathyroidism: which is primary, secondary and tertiary?

14- Cushing Syndrome vs Cushing Disease.

15- What is Addison’s Disease and symptoms?

16- Pheochromocytoma. Hormone in excess and symptoms.

17- Obesity: concept. Visceral vs Peripheral

18- Diabetes Type 1 vs 2: mechanism of production (pathophysiology) What is A1C?

19- Clinical manifestations of DM Type 1 and DM Type 2?

20- What is Gestational Diabetes and why it occurs?

21- Which are the acute complications of Diabetes?

22- From chronic complications of diabetes which are Macro and Microvascular?

23- Why patients with type 2 Diabetes may not suffer from Ketoacidosis?

Part 3: Advanced Pathophysiology

Briefly answer the questions in a couple of lines. Do not include unsolicited information

Topic:  Endocrine System

1- What are hormones and its general characteristics?

2- Regulation of Hormone release based on negative feedback: post an example.

3- Explain up and down regulation of hormone receptors.

4- How does the Pituitary-Hypothalamic axis work?

5- Mention the Hormones released from Anterior and Posterior Pituitary gland.

6- Functions of Pineal Gland.

7- Complete for each of these glandular organs which are the hormones produced and which are the functions of these hormones.

Thyroid

Parathyroid

Pancreas (endocrine activity)

Adrenal (from cortex and medulla)

8- Content of Slide 55 in PPT repost here (forget this question)

9- What is…? Syndrome of inappropriate antidiuretic hormone (SIADH) secretion vs Diabetes Insipidus (types)

10- What is Hypopituitarism and Hyperpituitarism?

11- What happens with Hypersecretion of GH?

12- Thyroid disorders: Primary vs secondary. Thyrotoxicosis symptoms. Graves Disease: mechanism of production and symptoms. Hypothyroidism etiology and symptoms.

13- Hyperparathyroidism: which is primary, secondary and tertiary?

14- Cushing Syndrome vs Cushing Disease.

15- What is Addison’s Disease and symptoms?

16- Pheochromocytoma. Hormone in excess and symptoms.

17- Obesity: concept. Visceral vs Peripheral

18- Diabetes Type 1 vs 2: mechanism of production (pathophysiology) What is A1C?

19- Clinical manifestations of DM Type 1 and DM Type 2?

20- What is Gestational Diabetes and why it occurs?

21- Which are the acute complications of Diabetes?

22- From chronic complications of diabetes which are Macro and Microvascular?

23- Why patients with type 2 Diabetes may not suffer from Ketoacidosis?

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Advanced Pharmacology Complementary And Alternative Healthcare And Crisis In Nursing Intervention

1) Minimum 12 pages  (No word count per page)- Follow the 3 x 3 rule: minimum of three paragraphs per page

You must strictly comply with the number of paragraphs requested per page

.

           Part 1: minimum  2 pages

           Part 2: minimum  3 pages

           Part 3: minimum  7 pages (Due 40 hours)

Submit 1 document per part

2)¨******APA norms

All paragraphs must be narrative and cited in the text- each paragraph

         Bulleted responses are not accepted

         Don’t write in the first person 

Don’t copy and paste the questions.

Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

Part 2: Minimum 5 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

Part 3: Minimum 7 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed.

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc

__________________________________________________________________________________

Part 1: Advanced Pharmacology

HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief. She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin AF cream and it did not help relief her symptoms. She has not tried other remedies. Denies associated symptoms of fever and chills.

PMH:

Diabetes Mellitus, type 2.

Surgeries: None

Allergies: Augmentin

Medication: Metformin 500mg PO BID.

Vaccination History: Immunization is up to date and she received her flu shot this year.

Social history:

College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago.

Family history:

Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, HTN.

Primary Diagnosis: Proximal subungual onychomycosis

1. Specify when to refer the patient after therapy and why? Provide rationale (One paragraph)

2. Describe three non-pharmacological approaches to Onychomycosis?  (One paragraph)

3. Provide patient education. Keep in mind the past medical history of this patient  (One paragraph)

Part 2: Complementary and alternative healthcare 

“Every serious illness is a spiritual crisis because it is a confrontation with one’s own mortality. Every nurse, regardless of personal belief, must recognize that religion or spirituality or both are often an essential part of the lives of those entrusted to her or his care. To avoid these issues is to fail to truly be a nurse healer because the nurse’s task is to address the physical, psychological, and spiritual needs of clients.” (Fontaine, 2019).

1. Introduction (One paragraph)

2. Discussing how nurses can incorporate faith and prayer in the care of patients (Two paragraphs)

3. How the nurses, regardless of their own personal religious beliefs and worldviews, must respect the faith and prayer in the care of patients (Two  paragraphs)

4. What is the benefit to nurses and patients when the nurses incorporate faith and prayer in the care of patients (Three  paragraphs)

5. Conclusion  (One  paragraph)

Part 3: Crisis in nursing intervention (Due 40 hours)

Topic: Chemical Dependency: The Crisis of Addiction

1. Abstract (One paragraph)

2. What is Chemical dependency? (Two paragraphs)

3. Describe the Statistics data/ Incidence at: (Three paragraphs)

a. Global

b. National

c. Local (Florida)

4. Sociocultural determinants of substance abuse (Three paragraphs)

5. Describe 2 models of addiction (Two paragraphs)

6. Describe dynamics of addiction (Two paragraphs)

7. Describe interventions Strategies: (Three paragraphs)

a. Psychological

b.Pharmacological

c. Non-pharmacological)

8. Describe considerations of management of behaviors in Partner, including (Two paragraphs)

a. Family considerations

b. Challenges in the care of patients with this social issue.

9. Describe different perspectives that support the identification of clinical problems from (Two paragraphs)

a. One evidence-based practice guidelines/research

b. One nursing theories

10. Conclusion (One paragraph)

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Health Reform

1) Students will select a state health policy reform innovation and

2) describe the rationale, how it was adopted (e.g., federal waivers, passage by state legislature),

3) the funding structure (How money is spent)

4) its impact (to the extent statistical data are available)

Students should summarize their findings in a 1-2 page, single-spaced Memo (Research how to write (format) a memo).

A few examples of state innovations include Vermont’s single payer system, Massachusetts’ health

reforms and Kentucky’s Medicaid healthcare program.

(None of these can be used).

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Theory Week 6

Theory Week 6

How does the concept of Modeling & Role Modeling apply to nursing?

How would the Theory of Integral Nursing benefit our community?

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How to Reduce Heparin Drips Administration Errors

Introduction and problem statement

Heparin is an anticoagulant drug used for various uses, including thromboembolic prophylaxis and treatment and the management of central venous access. It comes in different concentrations (1000 units/mL or greater) for therapeutic and prophylactic usage and lower concentrations, that is 100 units/mL or less, used in heparin lock flushing solutions. Heparin administration is greatly associated with medical errors resulting in severe consequences on patients’ health (Warnock & Huang, 2019, p. 49). Three high-profile occurrences involving this medicine at three prominent US institutions brought safety concerns about heparin use to the forefront. The Joint Commission’s National Patient Safety Goal (NPSG) 03.05.01, “lower the chances of patient harm due to anticoagulant medication use,” emphasizes the safe anticoagulant therapy use and monitoring.

Despite a previous attempt in a large Midwestern hospital to develop standard heparin administration procedures using a computerized system, errors continued to occur at unacceptably high rates. Heparin Error Reduction Workgroup (HERW) was formed in 2002, by pharmacists, staff nurses, and cardiologists. The HERW hired consultants of human factors to conduct an analysis of the human factors process of heparin administration among the nursing staff (Treiber & Jones, 2018, p. 159). Between 1999 and 2003, heparin was the most commonly used medicine in 14,800 ED medication mistakes.

Heparin is a medication that, if used wrongly, can result in serious hemorrhagic complications. Over five years, heparin dosing in large metropolitan hospitals with evolution has become more difficult. Heparin was formerly prescribed and monitored unevenly by physicians (Lee & Riley, 2021, p. 515). Heparin dose regimens were established and applied to ensure standardized dosing, optimized therapy, and reduced hazards. The dosing methods grew in number as heparin administration became more sophisticated and patient-specific. The protocols were originally only available on written paper. The benefits of computerized access in drug administration were exploited to improve protocol delivery and boost upgrade efficiency. Interactive computer software was developed to make protocol usage easier.

Three premature newborns died due to drug errors in an Indiana hospital that drew national attention. The Heparin overdoses were accidentally given to newborns because the incorrect strength was utilized to prepare umbilical line flushing solutions. The mistake occurred when 1 mL vials were accidentally put in a unit-based automated dispensing cabinet (ADC) where heparin 10,000 units/ml, 1 ml vials were commonly kept (Lee & Riley, 2021, p. 519). Nothing can take away the families’ pain in the aftermath of this unfortunate tragedy, and this keeps reminding us of the necessity to take precautions and closer examination of heparin use in our institutions.

The use of heparin includes;

· Prevention of enlargement of existing clots.

· Treatment and prevention of pulmonary emboli and deep venous thrombosis (Warnock & Huang, 2019, p. 49).

· Decreasing the risk of the development of blood clots.

· Maintaining patency of indwelling venous catheters.

The significance of Heparin administration errors administration to nursing.

Medicine errors can happen during any stage of the process of medication administration, including prescribing, transcription, dispense, and administration. However, previous researches have shown that pharmaceutical errors are more frequent during the phase of drug administration. This is because nurses administer the majority of the drugs. Heparin, for instance, is commonly administered and monitored by nurses (Warnock & Huang, 2019, p. 49). The nurses receive the clients’ medication upon prescription and dispatch and administer. Nurses can ensure improved patient safety through interruption of medication errors before reaching the client through adhering with six drug delivery rights and reporting of the problem.

Nurses confront problems in many facets of their work, particularly when safely providing and monitoring medications. General drug information and knowledge, formal nursing education, continuous education needs, clinical area experience, and nursing shortage nationwide are all recognized to impact client drug administration (Santomauro et al., 2021, p. 449). Other causes include technological advancements and quality-improvement programs. Patient safety is becoming more important, especially regarding medication therapies and high-alert drugs like unfractionated heparin (UFH). Specific UFH administration treatments can improve patient care management. Nurses are generally in a good position to spot pharmaceutical errors because they are on the front lines of patient care. On the other hand, nurses must work closely with other healthcare providers to achieve their goals.

The nurses should countercheck the medication dosage and administer them in the correct dosage. The nurses may prepare the heparin with different strengths wrongly, thus resulting in various errors. In addition, the preparation and administration of heparin differ in different types of heparin strengths. The errors also occur due to storage of heparin with different strengths in one place, poor documentation of the prescribed heparin in the ED, lack of individual/ independent double-checking of the heparin administration dosage, and incorrect programming of the infusion pumps (Gray, 2018, p. 369). These errors often occur among the nursing staff. Therefore, nurses should consistently check and document the heparin before administering it to the client. They should also independently double-check the heparin to prevent medication dose calculation errors. They should also ensure that the infusion pumps are correctly programmed to prevent over coagulation of the client’s blood.

Research purpose

The purpose of this research is to evaluate the causes of heparin drip administration errors and the ways through which these errors can be reduced. The heparin drips administration errors are very common and result in serious complications, at times, death of the clients. Despite the improvement in the majority of the errors that occur with heparin administration, such as the wrong client, several other errors have occurred with the administration of the heparin medication. 2.01 errors occur in 1000 heparin doses charged. The errors occur due to the incorrect handling of the heparin medication by different hospital personnel, such as pharmacists and physicians; however, most of the errors often occur from the nursing staff (Litman, 2018, p. 439). Therefore, the research paper aims to determine the causes of these errors and how to prevent them from occurring.

Research Questions

The research purposes to answer the following research questions;

1. What is the prevalence of heparin drips administration errors?

2. What are the factors associated with heparin drip administration errors?

3. How can heparin drip administration errors be prevented?

Conclusion

Intravenous heparin is used in the prevention of thrombosis in various clinical settings. It is considered a high-risk medication used in inpatient settings, commonly critical care units. The variation in the heparin administration protocols contributes to the majority of the drug errors associated with serious complications and mortalities. Some of these causes include drug dose calculation and preparation errors. Some of the prevention of heparin drip infusion errors include independent double-checking of the medication dose and preparation, correct programming of the infusion pumps, and clear documentation of the administered heparin dosage. However, there is a need to find out more about errors associated with heparin administration, their causes, and prevention to reduce the complications that occur with the errors.

References

Gray, G. (2018). Commentary: Improving Care through Innovations in Infusion Systems. Biomedical Instrumentation & Technology, 52(5), 366-371.

/orders/pdf.manuscriptpro.com/search/Abstract~30260667/1/cda77bb7/Commentary:-Improving-Care-through-Innovations-in-Infusion-Systems.

Lee, M. H., & Riley, W. (2021). Factors associated with errors in the heparin dose-response test: recommendations to improve individualized heparin management in cardiopulmonary bypass. Perfusion, 36(5), 513-523./orders/pubmed.ncbi.nlm.nih.gov/32909506/

Litman, R. S. (2018). How do we prevent medication errors in the operating room? Take away the human factor. British Journal of Anaesthesia, 120(3), 438-440. /orders/pubmed.ncbi.nlm.nih.gov/29452799/

Santomauro, C., Powell, M., Davis, C., Liu, D., Aitken, L. M., & Sanderson, P. (2021). Interruptions to intensive care nurses and clinical errors and procedural failures: A controlled study of causal connection. Journal of Patient Safety, 17(8), e1433-e1440. 441-461. /orders/pubmed.ncbi.nlm.nih.gov/30113425/

Treiber, L. A., & Jones, J. H. (2018). Making an infusion error. Journal of Infusion Nursing, 41(3), 156-163. /orders/pubmed.ncbi.nlm.nih.gov/29659462/

Warnock, L. B., & Huang, D. (2019). Heparin. /orders/pubmed.ncbi.nlm.nih.gov/30855835/

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Research Discussion 4

Chapter 10: Validity

Chapter 11: Trustworthiness of qualitative research

Read Chapter 10 & 11 

Discussion # 4 

Discussion topic for Week 7

Based on your readings, please answer the following discussion question.

What are the perceived challenges do you expect to find with validity and trustworthiness in qualitative research? What steps will you implement to ensure that your research is reliable?

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Reflection Research

Reflection Post Assignments

·  the student will have to post a reading reflection paragraph (5-6 sentences, with reference material) regarding the assigned chapters of that week. These posts will be counted towards participation grade. They are worth one point each.

Chapter 8: Sampling

Chapter 9: Reliability

Read Chapter 8 & 9

Reading Reflection 1 Ch 8 & 9

Reading Reflection Chap. 8 & 9 for Week Six.

Book:  Publication Manual American Psychological Association (APA) (7th ed.). 2020. ISBN-13:978-1433832161. ISBN-10: 143383216X

Ruth M. Tappen. (2015). Nursing Research. Advanced Nursing Research: From Theory to Practice. (2nd ed.). ISBN-13: 9781284048308. ISBN-10: 1284048306. Publisher: Jones & Bartlett Learning

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Relativism And Situation Ethics

The ethical theories called RELATIVISM and SITUATION ETHICS seem to be rampant in our society today many times overwhelming people with who have a well-developed sense of CONSCIENCE.

• Define these terms
• Do you agree or disagree with the above statement and WHY?
• Defend your position with some examples

   

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Reflection- Care Policy

1. (a) Name the first Registered Nurse elected to Congress in the United States (b) name the state affiliated (c) List at least one contribution (Policy) enacted since holding office.

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Nutrition

In this video a 12 year old girl, Briana, is struggling with morbid obesity. She weighs over 300 pounds. She has been told that being this overweight will affect her health. She also feels very self-conscious about her weight and is bullied by her classmates. Briana’s parents express concern about her health as well. When her mother is interviewed about what food she serves the family she appears to be very interested in making any necessary changes. A trip to the market to find out what she purchases for family meals reveals that she does not seem to know what would be best to prepare for Briana so she can lose weight. Briana’s mother appears to be “stuck” on buying what she thinks are healthy foods which includes canned vegetables and very little fresh fruit and vegetables.

Here is the link to the video, “A 12 Year Old’s Struggle with Morbid Obesity“

Describe how Briana’s mother should change meal preparations to be healthier. Describe strategies that might engage Briana in the process of preparing the meals.

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