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Week 3 discussion
Discussion: Pharmacotherapy for Cardiovascular Disorders
As the leading cause of death in the United States for both
men and women, cardiovascular disorders account for 7 million hospitalizations
per year (NCSL, 2012). This is the result of the extensive treatment and care
that is often required for patients with these disorders. While the incidences
of hospitalizations and death are still high, the mortality rate of
cardiovascular disorders has been declining since the 1960s (CDC, 2011).
Improved treatment options have contributed to this decline, as well as more
knowledge on patient risk factors. As an advanced practice nurse, it is your
responsibility to recommend appropriate treatment options for patients with
cardiovascular disorders. To ensure the safety and effectiveness of drug
therapy, advanced practice nurses must consider aspects that might influence
pharmacokinetic and pharmacodynamic processes such as medical history, other
drugs currently prescribed, and individual patient factors.
Consider the following case studies:
Case Study 1:
Patient AO has a history of obesity and has recently gained
9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia.
Drugs currently prescribed include the following:
Atenolol 12.5 mg daily
Doxazosin 8 mg daily
Hydralazine 10 mg qid
Sertraline 25 mg daily
Simvastatin 80 mg daily
Case Study 2:
Patient HM has a history of atrial fibrillation and a
transient ischemic attack (TIA). The patient has been diagnosed with type 2
diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs
currently prescribed include the following:
Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun
Aspirin 81 mg daily
Metformin 1000 mg po bid
Glyburide 10 mg bid
Atenolol 100 mg po daily
Motrin 200 mg 1–3 tablets every 6 hours as needed for pain
Case Study 3:
Patient CB has a history of strokes. The patient has been
diagnosed with type 2 diabetes, hypertension, and hyperlipidemia. Drugs
currently prescribed include the following:
Glipizide 10 mg po daily
HCTZ 25 mg daily
Atenolol 25 mg po daily
Hydralazine 25 mg qid
Simvastatin 80 mg daily
Verapamil 180 mg CD daily
To prepare:
Review this week’s media presentation on hypertension and
hyperlipidemia, as well as Chapters 19 and 20 of the Arcangelo and Peterson
text.
Select one of the three case studies, as well as one the
following factors: genetics, gender, ethnicity, age, or behavior factors.
Reflect on how the factor you selected might influence the
patient’s pharmacokinetic and pharmacodynamic processes.
Consider how changes in the pharmacokinetic and
pharmacodynamic processes might impact the patient’s recommended drug therapy.
Think about how you might improve the patient’s drug therapy
plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on
whether you would modify the current drug treatment or provide an alternative
treatment option for the patient.
With these thoughts in mind:
By Day 3
Post an explanation of how the factor you selected might
influence the pharmacokinetic and pharmacodynamic processes in the patient from
the case study you selected. Then, describe how changes in the processes might
impact the patient’s recommended drug therapy. Finally, explain how you might
improve the patient’s drug therapy plan.
By Day 6
Read a selection of your colleagues’ responses and respond
to at least two of your colleagues on two different days who selected a
different case study than you did, in one or more of the following ways:
Provide alternative recommendations for drug treatments.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.

Week 1 discussion
Factors That
Influence Disease
In clinical settings, some of the most common questions that
patients ask are Why do I have this? What caused this disorder? Will it ever go
away? These emotional questions can be difficult to ask and to answer. However,
for patients to come to terms with their diagnoses and adhere to treatment
plans, they must have an understanding of factors that might have caused, or
continue to impact, their disorders. As an advanced practice nurse, it is
important that you are able to explain disorders, associated alterations and
symptoms, and changes that might occur within your patients’ bodies.
To prepare:
Review this week’s media presentation with Dr. Terry
Buttaro. Reflect on the importance of developing an in-depth understanding of
pathophysiology.
Select a disorder from the following list:
Adrenal insufficiency (Addison’s disease)
Atherosclerosis
Cholelithiasis (gallstones)
Colon cancer
Cystic fibrosis
Hemophilia
Nephrolithiasis (kidney stones)
Osteoporosis
Parkinson’s disease
Tuberculosis
Select one of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how that factor might impact
your selected disorder, as well as potential associated alterations and
symptoms.
Identify the pathophysiology of the associated alterations,
including the normal and altered cellular function. Consider both intra- and
extra-cellular changes that occur.
By Day 3
Post a brief description of a patient scenario involving the
disorder and the factor you selected. Explain how the factor might impact your
selected disorder, as well as potential associated alterations and symptoms.
Finally, explain the pathophysiology of the associated alterations, including
changes in cellular function.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different disorders and factors than you, in the following
ways:
Share insights on how the factor you selected impacts the
pathophysiology of the disorder your colleague selected.
Expand on your colleague’s posting by providing additional
insights or contrasting perspectives based on readings and evidence.

Week 2 discussion
DQ1
Maladaptive Responses
to Immune Disorders
Maladaptive responses to disorders are compensatory
mechanisms that ultimately have adverse health effects for patients. For
instance, a patient’s allergic reaction to peanuts might lead to anaphylactic
shock, or a patient struggling with depression might develop a substance abuse
problem. To properly diagnose and treat patients, advanced practice nurses must
understand both the pathophysiology of disorders and potential maladaptive
responses that some disorders cause.
Consider immune disorders such as HIV, psoriasis,
inflammatory bowel disease, and systemic lupus E. What are resulting
maladaptive responses for patients with these disorders?
To prepare:
Review Chapter 5 and Chapter 7 in the Huether and McCance
text. Reflect on the concept of maladaptive responses to disorders.
Select two of the following immune disorders: HIV,
psoriasis, inflammatory bowel disease, or systemic lupus E (SLE).
Identify the pathophysiology of each disorder you selected.
Consider the compensatory mechanisms that the disorders trigger. Then compare
the resulting maladaptive and physiological responses of the two disorders.
Select one of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how the factor might impact your
selected immune disorders.
By Day 3
Post a brief description of the pathophysiology of your
selected immune disorders. Explain how the maladaptive and physiological
responses of the two disorders differ. Finally, explain how the factor you
selected might impact the pathophysiology of each disorder.
Read a selection of your colleagues’ responses.
By Day 5
Respond to at least two of your colleagues on two different
days who selected different immune disorders and/or factors than you, in the
following ways:
Share insights on how the factor you selected impacts the
pathophysiology of the immune disorder your colleague selected.
Expand on your colleague’s posting by providing additional
insights or contrasting perspectives based on readings and evidence.

DQ2
Arthritis
While arthritis impacts nearly 50 million adults in the
United States, it is not a disease that is limited to adulthood. Consider the
case of Ashley Russell. At the age of 14 months, Ashley was diagnosed with
juvenile rheumatoid arthritis. As a baby, her parents noticed that her knee was
always swollen and that she often wanted to be carried instead of walking on
her own (Cyr, 2012). After seeking medical care, Ashley’s underlying disorder
was discovered. Arthritis in children is not uncommon. According to the CDC
(2011), an estimated 294,000 children under age 18 have some form of arthritis
or rheumatic condition. Due to the prevalence of the disorder in both children
and adults, you must understand the pathophysiology and symptoms of arthritis
in order to properly diagnose and prescribe treatment.
To prepare:
Review Chapter 37 in the Huether and McCance text and
Chapter 24 in the McPhee and Hammer text. Identify the pathophysiology of
osteoarthritis and rheumatoid arthritis. Consider the similarities and
differences of the disorders.
Select two of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how the factors you selected
might impact the pathophysiology of the disorders, as well as the diagnosis of
and treatment for the disorders.
By Day 4
Post a description of the pathophysiology of osteoarthritis
and rheumatoid arthritis, including the similarities and differences between
the disorders. Then explain how the factors you selected might impact the
pathophysiology of the disorders, as well as the diagnosis of treatment for the
disorders.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different factors than you, in one or more of the following
ways:
Offer alternative diagnoses and prescription of treatment
options for osteoarthritis and rheumatoid arthritis.
Share an insight from having read your colleague’s posting,
synthesizing the information to provide new perspectives.

Week 3 discussion
Pain
The neurological system affects all parts and functions of
the body through nerve stimulation. Nerves also control the sensation and
perception of pain. While pain can be described in a variety of ways, it is
essentially labeled according to its duration and source. As an advanced
practice nurse evaluating a patient, you need to consider the following
questions: Does the pain quickly come and go, or is it persistent and ongoing?
Does the pain arise at the source of injury or in another location? In this
Discussion, you compare three common types of pain—acute, chronic, and
referred.
To prepare:
Review this week’s media presentation on the neurological
system, as well as Chapter 13 in the Huether and McCance text.
Identify the pathophysiology of acute, chronic, and referred
pain. Consider the similarities and differences between these three types of
pain.
Select two of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how the factors you selected
might impact the pathophysiology, diagnosis, and prescription of treatment for
acute, chronic, and referred pain.
By Day 3
Post a description of the pathophysiology of acute, chronic,
and referred pain, including similarities and differences between them. Then,
explain how the factors you selected might impact the pathophysiology, diagnosis,
and prescription of treatment for acute, chronic, and referred pain.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different factors than you, in the following ways:
Share insights on how your colleague’s factors impact the
pathophysiology of pain.
Suggest alternative diagnoses and treatment options for
acute, chronic, and referred pain.

Week 4 discussion
Cardiovascular
Disorders
Veins and arteries are vital elements of the cardiovascular
system. They carry the blood supply through the body and are essential for
proper function. Sometimes veins and arteries malfunction, resulting in
cardiovascular disorders. Malfunctions of arteries and veins are similar to
malfunctions of a water hose. Consider the structure and function of a hose. A
tap releases water, which then travels through the hose and comes out the other
end. If the hose has been dormant for several months, dirt and rusty particles
might build up inside, resulting in a restricted flow of water. Similarly,
buildup of plaque inside the coronary arteries restricts blood flow and leads
to disorders such as coronary heart disease. This disease is one of the most
common cardiovascular disorders, and according to the National Heart, Lung and
Blood Institute (2011), is the leading cause of death for men and women in the
United States. In this Discussion, you examine the pathophysiology of
cardiovascular disorders such as coronary heart disease.
To prepare:
Review this week’s media presentation on alterations of
cardiovascular functions, as well as Chapter 23 in the Huether and McCance
text. Identify the pathophysiology of cardiovascular disorders.
Select one patient factor: genetics, gender, ethnicity, age,
or behavior. Consider how the factor you selected might impact the
pathophysiology of cardiovascular disorders.
Select one of the following alterations of cardiovascular
disorders: peripheral arterial disease, myocardial infarction, coronary artery
disease, congestive heart failure, or dysrhythmia. Think about how hypertension
or dyslipidemia can lead to the alteration you selected.
By Day 3
Post a description of the pathophysiology of cardiovascular
disorders, including how the factor you selected might impact the
pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the
alteration you selected for patients with the factor you identified
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different alterations and factors than you, in one or more of
the following ways:
Share insights on how the factor you selected impacts the
cardiovascular alteration your colleague selected.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.

Week 5 discussion
DQ1
Cardiovascular
Disorders
At least once a year, the media report on a seemingly
healthy teenage athlete collapsing during a sports game and dying of heart
complications. These incidents continue to outline the importance of physical
exams and health screenings for teenagers, especially those who play sports.
During these health screenings, examiners check for cardiovascular alterations
such as heart murmurs because they can be a sign of an underlying heart
disorder. Since many heart alterations rarely have symptoms, they are easy to
miss if health professionals are not specifically looking for them. Once
cardiovascular alterations are identified in patients, it is important to refer
them to specialists who can further investigate the cause.
Consider the following scenario:
A 16-year-old male presents for a sports participation
examination. He has no significant medical history and no family history suggestive
of risk for premature cardiac death. The patient is examined while sitting
slightly recumbent on the exam table and the advanced practice nurse
appreciates a grade II/VI systolic murmur heard loudest at the apex of the
heart. Other physical findings are within normal limits, the patient denies any
cardiovascular symptoms, and a neuromuscular examination is within normal
limits. He is cleared with no activity restriction. Later in the season he
collapses on the field and dies.
To prepare:
Review the scenario provided, as well as Chapter 24 in the
Huether and McCance text. Consider how you would diagnose and prescribe
treatment for the patient.
Select one of the following patient factors: genetics,
ethnicity, or behavior. Reflect on how the factor you selected might impact
diagnosis and prescription of treatment for the patient in the scenario.
By Day 3
Post a description of how you would diagnose and prescribe
treatment for the patient in the scenario. Then explain how the factor you
selected might impact the diagnosis and prescription of treatment for that
patient.
Read a selection of your colleagues’ responses.
By Day 5
Respond to at least two of your colleagues who selected a
different factor than you, in one of the following ways:
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Share insights based on your own experience and additional
research.

DQ2
Anaphylactic Shock
The treatment of anaphylactic shock varies depending on a
patient’s physiological response to the alteration. Immediate medical
intervention and emergency room visits are vital for some patients, while
others can be treated through basic outpatient care.
Consider the January 2012 report of a 6-year-old girl who
went to her school nurse complaining of hives and shortness of breath. Since
the school did not have any medication under her name to use for treatment and
was not equipped to handle her condition, she was sent to an emergency room
where she was pronounced dead. This situation has raised numerous questions
about the progression of allergic reactions, how to treat students with severe
allergies, how to treat students who develop allergic reactions for the first
time, and the availability of epinephrine in schools. If you were the nurse at
the girl’s school, how would you have handled the situation? How do you know
when it is appropriate to treat patients yourself and when to refer them to
emergency care?
To prepare:
Review “Anaphylactic Shock” in Chapter 23 of the Huether and
McCance text, “Distributive Shock” in Chapter 10 of the McPhee and Hammer text,
and the Jacobsen and Gratton article in the Learning Resources.
Identify the multisystem physiologic progression that occurs
in anaphylactic shock. Think about how these multisystem events can occur in a
very short period of time.
Consider when you should refer patients to emergency care
versus treating as an outpatient.
Select two patient factors different from the one you
selected in this week’s first Discussion: genetics, gender, ethnicity, age, or
behavior. Reflect on how the factors you selected might impact the process of anaphylactic
shock.
By Day 4
Post an explanation of the physiological progression that
occurs in anaphylactic shock. Then, describe the circumstances under which you
would refer patients for emergency care versus treating as an outpatient.
Finally, explain how the patient factors you selected might impact the process
of anaphylactic shock.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues who selected at
least one different factor than you in one of the following ways:
Share insights on how the factor your colleague selected
impacts the pathophysiology of anaphylactic shock.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.

Week 6 discussion
Respiratory
Alterations
In clinical settings, patients often present with various
respiratory symptoms such as congestion, coughing, and wheezing. While
identifying a symptom’s underlying illness can be challenging, it is essential
because even basic symptoms such as persistent coughing can be a sign of a more
severe disorder. Advanced practice nurses must be able to differentiate between
moderate and severe respiratory disorders, as well as properly diagnose and
prescribe treatment for their patients. For this reason, you must have an
understanding of the pathophysiology of respiratory disorders.
Consider the following three scenarios:
Scenario 1:
Ms. Teel brings in her 7-month-old infant for evaluation.
She is afraid that the baby might have respiratory syncytial virus (RSV) because
she seems to be coughing a lot, and Ms. Teel heard that RSV is a common
condition for infants. A detailed patient history reveals that the infant has
been coughing consistently for several months. It’s never seemed all that bad.
Ms. Teel thought it was just a normal thing, but then she read about RSV.
Closer evaluation indicates that the infant coughs mostly at night; and, in
fact, most nights the baby coughs to some extent. Additionally, Ms. Teel
confirms that the infant seems to cough more when she cries. Physical
examination reveals an apparently healthy age- and weight-appropriate,
7-month-old infant with breath sounds that are clear to auscultation. The
infant’s medical history is significant only for eczema that was actually quite
bad a few months back. Otherwise, the only remarkable history is an allergic
reaction to amoxicillin that she experienced 3 months ago when she had an ear
infection.
Scenario 2:
Kevin is a 6-year-old boy who is brought in for evaluation
by his parents. The parents are concerned that he has a really deep cough that
he just can’t seem to get over. The history reveals that he was in his usual
state of good health until approximately 1 week ago when he developed a
profound cough. His parents say that it is deep and sounds like he is barking.
He coughs so hard that sometimes he actually vomits. The cough is productive
for mucus, but there is no blood in it. Kevin has had a low-grade temperature
but nothing really high. His parents do not have a thermometer and don’t know
for sure how high it got. His past medical history is negative. He has never
had childhood asthma or RSV. His mother says that they moved around a lot in
his first 2 years and she is not sure that his immunizations are up to date.
She does not have a current vaccination record.
Scenario 3:
Maria is a 36-year-old who presents for evaluation of a
cough. She is normally a healthy young lady with no significant medical
history. She takes no medications and does not smoke. She reports that she was
in her usual state of good health until approximately 3 weeks ago when she
developed a “really bad cold.” The cold is characterized by a profound, deep,
mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary
problem is the cough. She develops these coughing fits that are prolonged, very
deep, and productive of a lot of green sputum. She hasn’t had any fever but
does have a scratchy throat. Maria has tried over-the-counter cough medicines
but has not had much relief. The cough keeps her awake at night and sometimes
gets so bad that she gags and dry heaves.
To prepare:
Review the three scenarios, as well as Chapter 26 and
Chapter 27 in the Huether and McCance text.
Select one of the scenarios and consider the respiratory
disorder and underlying alteration associated with the type of cough described.
Identify the pathophysiology of the alteration that you
associated with the cough.
Select two of the following factors: genetics, gender,
ethnicity, age, or behavior. Reflect on how the factors you selected might
impact the disorder.
By Day 3
Post a description of the disorder and underlying
respiratory alteration associated with the type of cough in your selected
scenario. Then, explain the pathophysiology of the respiratory alteration.
Finally, explain how the factors you selected might impact the disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected a different scenario than you, in one or more of the
following ways:
Share insights on how the factor you selected impacts the
disorder your colleague identified.
Ask a probing question regarding the disorder that your
colleague identified.
Suggest an alternative disorder for the scenario your
colleague selected.

Week 7 discussion
Anemia
In clinical settings, advanced practice nurses often
encounter patients with blood disorders such as anemia. Consider the case of a
17-year-old girl who is rushed to the emergency room after suddenly fainting.
The girl’s mother reports that her daughter has had difficulty concentrating
for the past week, frequently becomes dizzy, and has not been eating normally
due to digestion problems. The mother also informs the nurse that their family
has a history of anemia. With the family history of anemia, it appears that
this is the likely diagnosis. However, in order to properly diagnose and treat
the patient, not only must her symptoms and family history be considered, but
also factors such as gender, ethnicity, age, and behavior. This poses the
question: How do patient factors impact the incidence and prevalence of
different types of anemia?
To prepare:
Review Chapter 20 in the Huether and McCance text. Reflect
on the pathophysiological mechanisms of iron deficiency anemia.
Select one of the following types of anemia: pernicious
anemia, folate deficiency anemia, sideroblastic anemia, chronic inflammation
anemia, or post-hemorrhagic anemia. Identify the pathophysiological mechanisms
of the anemia you selected.
Consider the similarities and differences between iron
deficiency anemia and the type of anemia you selected.
Reflect on how patient factors such as genetics, gender,
ethnicity, age, and behavior might impact these anemic disorders.
By Day 3
Post an explanation of the pathophysiological mechanisms of
iron deficiency anemia and the anemia you selected. Compare these two types of
anemia, as well as their potential causes. Finally, explain how genetics,
gender, ethnicity, age, and behavior might impact the anemic disorders you
selected.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different types of anemia than you, in the following ways:
Share insights on how the anemia you selected is similar to
or different from the one your colleague selected.
Discuss how genetic, gender, ethnic, age, and behavioral
factors impact the diagnosis and prescription of treatment for anemic patients.

Week 8 discussion
Digestive Disorders
Many patient symptoms can be tied to multiple disorders,
which may lead to misdiagnoses. For instance, consider two digestive disorders
of the gastrointestinal tract—inflammatory bowel disease and irritable bowel
syndrome. These two disorders are commonly confused because they present similar
symptoms. As an advanced practice nurse, you must know the differences to
properly diagnose and treat the disorders. How does the pathophysiology of
inflammatory bowel disease compare to the pathophysiology of irritable bowel
syndrome? How do treatments for the two disorders compare?
To prepare:
Review Chapter 34 in the Huether and McCance text and
Chapter 13 in the McPhee and Hammer text.
Identify the pathophysiological mechanisms of inflammatory
bowel disease and irritable bowel syndrome. Think about similarities and
differences between the disorders.
Consider common treatments for inflammatory bowel disease
and irritable bowel syndrome. Reflect on whether treatments for one disorder
would work for the other disorder.
Select one of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how the factor you selected
might impact the pathophysiology of and treatments for each disorder.
By Day 3
Post an explanation of the pathophysiological mechanisms of
inflammatory bowel disorder and irritable bowel syndrome, including
similarities and differences. Then describe common treatments, addressing
whether treatments for one disorder would work for the other disorder. Finally,
explain how the patient factor you selected might impact the pathophysiology of
and treatments for each disorder.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different treatments and factors than you, in the following
ways:
Offer alternative common treatments for the disorders.
Share insight on how the factor you selected impacts the
treatment of alterations of digestive function.

Week 9 discussion
Diabetes
According to the American Diabetes Association (2011), 25.8
million children and adults have been diagnosed with diabetes in the United
States. Approximately 2 million more are diagnosed every year, with another 79
million people considered to be in a pre-diabetes state. These millions of
people are at risk of several alterations, including heart disease, stroke,
kidney failure, neuropathy, and blindness. Since diabetes has a major impact on
the health of millions of people around the world, it is essential for nurses
to understand the pathophysiology and associated alterations of this disorder.
In this Discussion, you compare two types of diabetes—diabetes mellitus and
diabetes insipidus.
To prepare for this Discussion:
Review Chapter 18 in the Huether and McCance text and
Chapter 18 in the McPhee and Hammer text. Identify the pathophysiology of
diabetes mellitus and diabetes insipidus. Consider the similarities and
differences between resulting alterations of hormonal regulation.
Select two of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Think about how the factors you selected
might impact the diagnosis and prescription of treatment for these two types of
diabetes.
By Day 3
Post an explanation of the pathophysiology of diabetes
mellitus and diabetes insipidus. Describe the differences and similarities
between resulting alterations of hormonal regulation. Then explain how the
factors you selected might impact the diagnosis and prescription of treatment
for these two types of diabetes.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different factors than you, in one or more of the following
ways:
Share insights on how the factor you selected impacts the
pathophysiology of diabetes mellitus and diabetes insipidus.
Offer alternative diagnoses and prescription of treatment
options for diabetes mellitus and diabetes insipidus.
Validate an idea with your own experience and additional
research.
Reference:
American Diabetes Association. (2011). Diabetes
statistics. Retrieved from
http://www.diabetes.org/diabetes-basics/diabetes-statistics/

Week 10 discussion
Urinary Tract
Infections
Urinary tract infections (UTIs) are caused by bacteria—most
often Escherichia coli. However, certain viruses, fungi, and parasites can also
lead to infection. The infection can affect the lower and upper urinary tract,
including the urethra, prostate (in males), bladder, ureter, and kidney. Due to
the progression of the disease and human anatomy, symptoms present differently
among the sexes as well as among age groups. It is important to understand how
these factors, as well as others, impact the pathophysiology of UTIs. Advanced
practice nurses must have this foundation in order to properly diagnose
patients.
To prepare:
Review Chapter 29 in the Huether and McCance text. Identify
the pathophysiology of lower and upper urinary tract infections. Consider the
similarities and differences between the two types of infections.
Select two of the following patient factors: genetics,
gender, ethnicity, age, or behavior. Reflect on how the factors you selected
might impact the pathophysiology of the infections, as well as the diagnosis of
and treatment for the infections.
By Day 3
Post a description of the pathophysiology of lower and upper
urinary tract infections, including their similarities and differences. Then
explain how the factors you selected might impact the pathophysiology of the
infections, as well as the diagnosis of and treatment for the infections.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected at least one different factor than you, in one or more of the
following ways:
Offer alternative diagnoses and prescription of treatment
options for urinary tract infections.
Share an insight from having read your colleague’s posting,
synthesizing the information to provide new perspectives.

Week 11 discussion
Disorders of the
Reproductive Systems
While the male and female reproductive systems are unique to
each sex, they share a common function—reproduction. Disorders of this system
range from delayed development to structural and functional abnormalities.
Since many reproductive disorders not only result in physiological consequences
but also psychological consequences such as embarrassment, guilt, or profound
disappointment, patients are often hesitant to seek treatment. Advanced
practice nurses need to educate patients on disorders and help relieve
associated stigmas. During patient evaluations, patients must feel comfortable
answering questions so that you, as a key health care provider, will be able to
diagnose and recommend treatment options. As you begin this Discussion,
consider reproductive disorders that you would commonly see in the clinical
setting.
To prepare for this Discussion:
Review Chapter 22 and Chapter 23 in the McPhee and Hammer text,
as well as Chapter 32 in the Huether and McCance text.
Select two disorders of the male and/or female reproductive
systems that interest you. Consider the similarities and differences between
the disorders.
Select one of the following factors: genetics, ethnicity,
age, or behavior. Think about how the factor you selected might impact the
diagnosis of and treatment for the reproductive disorders.
By Day 3
Post a description of the two reproductive disorders you
selected, including their similarities and differences. Then explain how the
factor you selected might impact the diagnosis of treatment for the
reproductive disorders.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected different disorders or factors than you, in one or more of
the following ways:
Share insights on how the factor you selected impacts the
pathophysiology of the disorder your colleague selected.
Offer alternative diagnoses and prescription of treatment
options for the disorder your colleague selected.
Validate an idea with your own experience and additional
research.

Week 2 assignment
Assignment: Adaptive
Response
As an advanced practice nurse, you will examine patients
presenting with a variety of disorders. You must, therefore, understand how the
body normally functions so that you can identify when it is reacting to
changes. Often, when changes occur in body systems, the body reacts with
compensatory mechanisms. These compensatory mechanisms, such as adaptive
responses, might be signs and symptoms of alterations or underlying disorders.
In the clinical setting, you use these responses, along with other patient
factors, to lead you to a diagnosis.
Consider the following scenarios:
Scenario 1:
Jennifer is a 2-year-old female who presents with her
mother. Mom is concerned because Jennifer has been “running a temperature” for
the last 3 days. Mom says that Jennifer is usually healthy and has no
significant medical history. She was in her usual state of good health until 3
days ago when she started to get fussy, would not eat her breakfast, and would
not sit still for her favorite television cartoon. Since then she has had a
fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has
been giving her ibuprofen, but when the fever went up to 103.2oF today, she
felt that she should come in for evaluation. A physical examination reveals a
height and weight appropriate 2-year-old female who appears acutely
unwell. Her skin is hot and dry. The
tympanic membranes are slightly reddened on the periphery, but otherwise normal
in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates.
Anterior cervical nodes are readily palpable and clearly tender to touch on the
left side. The child indicates that her throat hurts “a lot” and it is painful
to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats
per minute, and a respiratory rate of 24 beats per minute.
Scenario 2:
Jack is a 27-year-old male who presents with redness and
irritation of his hands. He reports that he has never had a problem like this
before, but about 2 weeks ago he noticed that both his hands seemed to be
really red and flaky. He denies any discomfort, stating that sometimes they
feel “a little bit hot,” but otherwise they feel fine. He does not understand
why they are so red. His wife told him that he might have an allergy and he
should get some steroid cream. Jack has no known allergies and no significant
medical history except for recurrent ear infections as a child. He denies any
traumatic injury or known exposure to irritants. He is a maintenance engineer
in a newspaper building and admits that he often works with abrasive solvents
and chemicals. Normally he wears protective gloves, but lately they seem to be
in short supply so sometimes he does not use them. He has exposed his hands to
some of these cleaning fluids, but says that it never hurt and he always washed
his hands when he was finished.
Scenario 3:
Martha is a 65-year-old woman who recently retired from her
job as an administrative assistant at a local hospital. Her medical history is
significant for hypertension, which has been controlled for years with
hydrochlorothiazide. She reports that lately she is having a lot of trouble
sleeping, she occasionally feels like she has a “racing heartbeat,” and she is
losing her appetite. She emphasizes that she is not hungry like she used to be.
The only significant change that has occurred lately in her life is that her
87-year-old mother moved into her home a few years ago. Mom had always been
healthy, but she fell down a flight of stairs and broke her hip. Her recovery
was a difficult one, as she has lost a lot of mobility and independence and
needs to rely on her daughter for assistance with activities of daily living.
Martha says it is not the retirement she dreamed about, but she is an only
child and is happy to care for her mother. Mom wakes up early in the morning,
likes to bathe every day, and has always eaten 5 small meals daily. Martha has
to put a lot of time into caring for her mother, so it is almost a “blessing”
that Martha is sleeping and eating less. She is worried about her own health
though and wants to know why, at her age, she suddenly needs less sleep.
To Prepare
Review the three scenarios, as well as Chapter 6 in the
Huether and McCance text.
Identify the pathophysiology of the disorders presented in
each of the three scenarios, including their associated alterations. Consider
the adaptive responses to the alterations.
Review the examples of “Mind Maps—Dementia, Endocarditis,
and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning
Resources. Then select one of the disorders you identified from the scenarios.
Use the examples in the media as a guide to construct a mind map for the
disorder you selected. Consider the epidemiology, pathophysiology, risk
factors, clinical presentation, and diagnosis of the disorder, as well as any
adaptive responses to alterations.
Review the Application Assignment Rubric found under Course
Information
To Complete
Write a 2- to 3-page paper excluding the title page,
reference page and Mind Map that addresses the following:
For each of the three scenarios explain the pathophysiology,
associated alterations and the patients’ adaptive responses to the alterations
caused by the disease processes. You are
required to discuss all three scenarios within the paper component of this
assignment.
Construct one mind map on a selected disorder presented in
one of the scenarios. Your Mind Map must include the epidemiology,
pathophysiology, risk factors, clinical presentation, and diagnosis of the
disorder, as well as any adaptive responses to alterations.

Week 4 assignment
Assignment: Disorders
of the Veins and Arteries
Advanced practice nurses often treat patients with vein and
artery disorders such as chronic venous insufficiency (CVI) and deep venous
thrombosis (DVT). While the symptoms of both disorders are noticeable, these
symptoms are sometimes mistaken for signs of other conditions, making the
disorders difficult to diagnose. Nurses must examine all symptoms and rule out
other potential disorders before diagnosing and prescribing treatment for
patients. In this Assignment, you explore the epidemiology, pathophysiology,
and clinical presentation of CVI and DVT.
To Prepare
Review the section “Diseases of the Veins” (pp. 598-599) in
Chapter 23 of the Huether and McCance text. Identify the pathophysiology of
chronic venous insufficiency and deep venous thrombosis. Consider the
similarities and differences between these disorders.
Select a patient factor different from the one you selected
in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think
about how the factor you selected might impact the pathophysiology of CVI and
DVT. Reflect on how you would diagnose and prescribe treatment of these
disorders for a patient based on the factor you selected.
Review the “Mind Maps—Dementia, Endocarditis, and
Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning
Resources. Use the examples in the media as a guide to construct two mind
maps—one for chronic venous insufficiency and one for venous thrombosis.
Consider the epidemiology and clinical presentation of both chronic venous
insufficiency and deep venous thrombosis.
To Complete
Write a 2- to 3-page paper that addresses the following:
Compare the pathophysiology of chronic venous insufficiency
and deep venous thrombosis. Describe how venous thrombosis is different from
arterial thrombosis.
Explain how the patient factor you selected might impact the
pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe
treatment of these disorders for a patient based on the factor you selected.
Construct two mind maps—one for chronic venous insufficiency
and one for deep venous thrombosis. Include the epidemiology, pathophysiology,
and clinical presentation, as well as the diagnosis and treatment you explained
in your paper.

Week 6 assignment
Assignment: Asthma
Complications of asthma can be sudden. Consider the case of
Bradley Wilson, a young boy who had several medical conditions. He appeared in
good health when he went to school, returned home, and ate dinner. However,
when he later went outside to play, he came back inside wheezing. An ambulance
took him to the hospital where he was pronounced dead (Briscoe, 2012). In
another case, 10-year-old Dynasty Reese, who had mild asthma, woke up in the
middle of the night and ran to her grandfather’s bedroom to tell him she
couldn’t breathe. By the time paramedics arrived, she had passed out and was
pronounced dead at the hospital (Glissman, 2012). These situations continue to
outline the importance of recognizing symptoms of asthma and providing
immediate treatment, as well as distinguishing minor symptoms from serious,
life-threatening symptoms. Since these symptoms and attacks are often induced
by a trigger, as an advanced practice nurse, you must be able to help patients
identify their triggers and recommend appropriate treatment options. For this
reason, you need to understand the pathophysiological mechanisms of chronic
asthma and acute asthma exacerbation.
To Prepare
Review “Asthma” in Chapter 27 of the Huether and McCance
text. Identify the pathophysiological mechanisms of chronic asthma and acute
asthma exacerbation. Consider how these disorders are similar and different.
Select a patient factor different from the one you selected
in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think
about how the factor you selected might impact the pathophysiology of both
disorders. Reflect on how you would diagnose and prescribe treatment of these
disorders for a patient based on the factor you selected.
Review the “Mind maps—Dementia, Endocarditis, and
Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning
Resources. Use the examples in the media as a guide to construct two mind
maps—one for chronic asthma and one for acute asthma exacerbation. Consider the
epidemiology and clinical presentation of both chronic asthma and acute asthma
exacerbation.
To Complete
Write a 2- to 3-page paper that addresses the following:
Describe the pathophysiological mechanisms of chronic asthma
and acute asthma exacerbation. Be sure to explain the changes in the arterial
blood gas patterns during an exacerbation.
Explain how the factor you selected might impact the
pathophysiology of both disorders. Describe how you would diagnose and
prescribe treatment for a patient based on the factor you selected.
Construct two mind maps—one for chronic asthma and one for
acute asthma exacerbation. Include the epidemiology, pathophysiology, and
clinical presentation, as well as the diagnosis and treatment you explained in
your paper.

Week 8 assignment
Gastrointestinal
Tract: Disorders of Motility
Jamie is a 3-month-old female who presents with her mother
for evaluation of “throwing up.” Mom reports that Jamie has been throwing up
pretty much all the time since she was born. Jamie does not seem to be sick. In
fact, she drinks her formula vigorously and often acts hungry. Jamie has normal
soft brown bowel movements every day and, overall, seems like a happy and
contented baby. She smiles readily and does not cry often. Other than the fact
that she often throws up after drinking a bottle, she seems to be a very
healthy, happy infant. A more precise history suggests that Jamie does not
exactly throw up—she does not heave or act unwell—but rather it just seems that
almost every time she drinks a bottle she regurgitates a milky substance. Mom
thought that she might be allergic to her formula and switched her to a
hypoallergenic formula. It didn’t appear to help at all, and now Mom is very
concerned.
Cases like these are not uncommon. The mother was concerned
and thinking her daughter may have an allergy; she changed to a different
formula. However, sometimes babies have immature GI tracts that can lead to
physiology reflux as they adapt to normal life outside the uterus. Parents
often do not consider this possibility, prompting them to change formulas
rather than seeking medical care. As in the case study above, GI alterations
can often be difficult to identify because many cause similar symptoms. This
same issue also arises with adults—adults may present with symptoms that have
various potential causes. When evaluating patients, it is important for the
advanced practice nurse to know the types of questions he or she needs to ask
to obtain the appropriate information for diagnosis. For this reason, you must
have an understanding of common GI disorders such as gastroesophageal reflux
disease (GERD), peptic ulcer disease (PUD), and gastritis.
To Prepare
Review this week’s media presentation on the gastrointestinal
system.
Review Chapter 35 in the Huether and McCance text. Identify
the normal pathophysiology of gastric acid stimulation and production.
Review Chapter 37 in the Huether and McCance text. Consider
the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer
disease (PUD), and gastritis. Think about how these disorders are similar and
different.
Select a patient factor different from the one you selected
in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider
how the factor you selected might impact the pathophysiology of GERD, PUD, and
gastritis. Reflect on how you would diagnose and prescribe treatment of these
disorders for a patient based on this factor.
Review the “Mind Maps—Dementia, Endocarditis, and
Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning
Resources. Use the examples in the media as a guide to construct a mind map for
gastritis. Consider the epidemiology and clinical presentation of gastritis.
To Complete
Write a 2- to 3-page paper that addresses the following:
Describe the normal pathophysiology of gastric acid
stimulation and production. Explain the changes that occur to gastric acid
stimulation and production with GERD, PUD, and gastritis disorders.
Explain how the factor you selected might impact the
pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose
and prescribe treatment of these disorders for a patient based on the factor
you selected.
Construct a mind map for gastritis. Include the epidemiology,
pathophysiology, and clinical presentation, as well as the diagnosis and
treatment you explained in your paper.

Week 10 assignment
The Pathophysiology of Disorders
During the last 5 weeks, you have explored various body
systems: neurological, cardiovascular, respiratory, and hematological. These
four systems work together along with other body systems to complete a myriad
of functions. For this reason, when disorders occur within one body system, it
can create potentially devastating effects throughout the entire body. For
instance, Parkinson’s disease is a disorder of the central nervous system, yet
its alterations actually affect multiple body systems from the cardiovascular
system to the gastrointestinal system. In this Assignment, you examine
alterations associated with disorders, as well as the impact of the alterations
on multiple body systems.
To Prepare
From the list below, select a disorder of interest to you:
Alzheimer’s disease
Asthma in children
Chronic obstructive pulmonary disease (COPD)
Congestive heart failure
Hepatic disease (liver disease)
Hypertension
Hyperthyroidism and hypothyroidism
Seizures
Sepsis
Identify alterations associated with your selected disorder.
Consider the pathophysiology of the alterations. Think about how these
alterations produce pathophysiological changes in at least two body systems.
Reflect on how patient factors such as genetics, gender,
ethnicity, age, and behavior might impact the pathophysiology of the
alterations you identified, as well as the diagnosis and treatment of your
selected disorder.
Review the “Mind maps—Dementia, Endocarditis, and
Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning
Resources. Use the examples in the media as a guide to construct a mind map for
the disorder you selected. Consider the epidemiology and clinical presentation
of your selected disorder.
To Complete
Develop a 5- to 10-slide PowerPoint presentation that
addresses the following:
Describe your selected disorder, as well as associated
alterations. Explain the pathophysiology of the alterations, including changes
that occur in at least two body systems.
Explain how genetics, gender, ethnicity, age, and behavior
might impact the pathophysiology of the alterations you identified, as well as
diagnosis and treatment of your selected disorder.
Construct a mind map for the disorder you selected. Include
the epidemiology, pathophysiology of alterations, risk factors, and clinical
presentation, as well as the diagnosis and treatment of the disorder.

<pclass=”msonormal”>Quiz 1
Question 1
A 20-year-old pregnant female gives birth to a stillborn
child. Autopsy reveals that the fetus has 92 chromosomes. What term may be on
the autopsy report to describe this condition?
Question 2
A group of prison inmates developed tuberculosis following
exposure to an infected inmate. On examination, tissues were soft and granular
(like clumped cheese). Which of the following is the most likely cause?
Question 3
A runner has depleted all the oxygen available for muscle
energy. Which of the following will facilitate his continued muscle
performance?
Question 4
The student is reviewing functions of the cell. The student
would be correct in identifying the primary function of the nerve cell as:
Question 5
Sodium and water accumulation in an injured cell are a
direct result of:

<pclass=”msonormal”>Week 2 quiz
Question 1
The incidence of fractures of the pelvis is highest in:
Question 2
The nurse would expect the occurrence of scabies to occur
more commonly among children who:
Question 3
A 51-year-old male experienced severe acute gouty arthritis.
Which of the following is the most common trigger for the symptoms?
Question 4
A patient has chicken pox. How does the varicella replicate?
Question 5
A 70-year-old female presents with a hip fracture secondary
to osteoporosis. This condition is caused by an increase in bone:

<pclass=”msonormal”>Week 3 quiz
Question 1
A 69-year-old male with a history of alcohol abuse presents
to the emergency room (ER) after a month-long episode of headaches and
confusion. Based on his alcoholism, a likely cause of his neurologic symptoms
is:
Question 2
A 40-year-old male complains of uncontrolled excessive
movement and progressive dysfunction of intellectual and thought processes. He
is experiencing movement problems that begin in the face and arms that
eventually affect the entire body. The most likely diagnosis is:
Question 3
A 60-year-old female with a recent history of head trauma
and a long-term history of hypertension presents to the ER for changes in
mental status. MRI reveals that she had a hemorrhagic stroke. What does the
nurse suspect caused this type of stroke?
Question 4
A patient with an addiction to alcohol checked into a
rehabilitation center. He experiences delirium, inability to concentrate, and
is easily distracted. From which of the following is he most likely suffering?
Question 5
When planning care for a child in pain, which principle
should the nurse remember? The pain threshold in children is _____ that of
adults.

<pclass=”msonormal”>Week 4 quiz
Question 1
Which of the following findings in the patient with Raynaud
disease would indicate a need for further teaching?
Question 2
A patient wants to know what causes atherosclerosis. How
should the nurse respond? In general, atherosclerosis is caused by:
Question 3
A 28-year-old female presents with severe chest pain and
shortness of breath. She is diagnosed with pulmonary embolism, which most
likely originated from the:
Question 4
Which characteristic changes should the nurse keep in mind
while caring for a patient with left heart failure? As left heart failure
progresses:
Question 5
A 50-year-old male visits the cardiologist for an EKG.
Results indicate that he has no PR interval and a variable QRS rate with rhythm
irregularity. Which of the following is the most likely diagnosis to be
recorded on the chart?

<pclass=”msonormal”>Week 5 quiz
Question 1
A nurse is planning care for a patient in shock. Which
principle should the nurse remember? During shock states, glucose uptake is
usually:
Question 2
A 20-year-old male underwent an echocardiogram to assess
chest pain. Results revealed a congenital defect in papillary muscles. Which of
the following would the nurse expect to occur?
Question 3
A 75-year-old male has severe chest pain and dials 911. Lab
tests at the hospital reveal elevated levels of cardiac troponins I and T.
Based upon the lab findings, the nurse suspects which of the following has
occurred?
Question 4
A 67-year-old female was previously diagnosed with rheumatic
heart disease. Tests reveal lipoprotein deposition with chronic inflammation
that impairs blood flow from the left ventricle into the aorta. Which of the
following is the most likely diagnosis recorded on the chart?
Question 5
A 20-year-old female is being admitted to the hospital with
fever and septic shock. Which set of assessment findings would the nurse expect
the patient to exhibit?

<pclass=”msonormal”>Week 6 quiz
Question 1
While planning care for a child with asthma, which of the
following is characteristic of asthma?
Question 2
Which patient would the nurse assess for paroxysmal
nocturnal dyspnea (PND)? A patient with:
Question 3
A 42-year-old female presents with dyspnea; rapid, shallow
breathing; inspiratory crackles; decreased lung compliance; and hypoxemia.
Tests reveal a fulminant form of respiratory failure characterized by acute
lung inflammation and diffuse alveolocapillary injury. Which of the following
is the most likely diagnosis the nurse will observe on the chart?
Question 4
A 65-year-old male recently had a cerebrovascular accident
that resulted in dysphagia. He now has aspiration of gastric contents. The
nurse assesses the patient for which complication?
Question 5
A nurse recalls asthma is classified by:

<pclass=”msonormal”>Week 7 quiz
Question 1
A nurse is caring for a patient who cannot clot. Which end
product of the clotting cascade is this patient unable to make?
Question 2
A 25-year-old female has a heavy menses during which she
loses a profuse amount of blood. Which of the following adaptations should the
nurse expect?
Question 3
A staff member wants to know where the greatest proportion
of iron is located. How should the nurse respond? The greatest proportion of
total body iron is located in the:
Question 4
A 65-year-old male experienced loss of appetite, weight
loss, lemon-yellow skin, liver enlargement, and a beefy red tongue shortly
before his death. Autopsy suggested pernicious anemia, and the cause of death
would most likely reveal:
Question 5
While reviewing lab results, the nurse recalls the most
abundant cells in the blood are:

<pclass=”msonormal”>Week 8 quiz
Question 1
For the patient experiencing esophageal reflux, the nurse
would expect which sphincter to be malfunctioning?
Question 2
The most common disorder associated with upper GI bleeding
is:
Question 3
A 27-year-old male presents with fever, GI bleeding,
hepatomegaly, and transient joint pain. He reports that as a child he received
blood transfusions following a motor vehicle accident. He also indicates he was
vaccinated against hepatitis B. Which of the following types of hepatitis does
the clinician think he most likely has?
Question 4
A 55-year-old male died in a motor vehicle accident. Autopsy
revealed an enlarged liver caused by fatty infiltration, testicular atrophy,
and mild jaundice secondary to cirrhosis. The most likely cause of his
condition is:
Question 5
Acute pancreatitis often manifests with pain to which of the
following regions?

<pclass=”msonormal”>Week 9 quiz
Question 1
A patient has high levels of hormones. To adapt to the high
hormone concentrations, the patient’s target cells have the capacity for:
Question 2
A patient has researched lipid-soluble hormones on the
Internet. Which information indicates the patient has a good understanding?
Lipid-soluble hormone receptors cross the plasma membrane by:
Question 3
A 50-year-old female presents with lightheadedness and
overall abnormal feelings. Hyperaldosteronism is diagnosed. Which of the
following symptoms would the nurse expect?
Question 4
A 12-year-old female is newly diagnosed with type 1 DM. When
the parents ask what causes this, what is the nurse’s best response?
Question 5
0 out of 1 points
A 30-year-old male was diagnosed with hypothyroidism. Synthesis
of which of the following would decrease in this patient?

<pclass=”msonormal”>Week 10 quiz
Question 1
A 15-year-old female presents with flank pain, irritability,
malaise, and fever. Tests reveal glomerulonephritis. When the parents ask what
could have caused this, how should the nurse respond?
Question 2
A 60-year-old male is diagnosed with renal failure. While
the nurse is reviewing lab results, which of the following lab values would be
most consistent with this diagnosis?
Question 3
A 7-year-old male presents to his primary care provider for
incontinence. His mother indicates that he has never been continent. Which of
the following is the most likely diagnosis the nurse will observe on the chart?
Question 4
If a nurse wants to obtain the best estimate of renal
function, which test should the nurse monitor?
Question 5
When a patient’s renal system secretes rennin, what effect
will that cause in the body? It causes the direct activation of:

<pclass=”msonormal”>Week 11 quiz
Question 1
A 68-year-old male presents complaining of difficulty having
sexual intercourse. He reports that his penis curves during erection. This
condition is referred to as:
Question 2
A 25-year-old sexually active female presents with
urethritis, dysuria, and cervical discharge. She is diagnosed with the most
common bacteria STI in the United States. The student would identify this
infection is due to:
Question 3
A middle-aged male speaks to his physician about benign BPH.
He reveals that his father was recently diagnosed with this condition, and he
wants to know if he could have it. The physician tells him that a common
complaint from men with mild to moderate BPH is:
Question 4
When a patient who is trying to get pregnant asks where the
usual site of fertilization is, how should the nurse respond? The:
Question 5
An example of a parasitic STI that is transmitted through
close skin-to-skin contact is:

week_11_quiz_.docx (44.5 KB)

Week 11 quiz
Question 1
A 68-year-old male presents complaining of difficulty having
sexual intercourse. He reports that his penis curves during erection. This
condition is referred to as:
Question 2
A 25-year-old sexually active female presents with
urethritis, dysuria, and cervical discharge. She is diagnosed with the most
common bacteria STI in the United States. The student would identify this
infection is due to:
Question 3
A middle-aged male speaks to his physician about benign BPH.
He reveals that his father was recently diagnosed with this condition, and he
wants to know if he could have it. The physician tells him that a common
complaint from men with mild to moderate BPH is:
Question 4
When a patient who is trying to get pregnant asks where the
usual site of fertilization is, how should the nurse respond? The:
Question 5
An example of a parasitic STI that is transmitted through
close skin-to-skin contact is:
Question 6
The nurse would anticipate the treatment for pelvic organ
prolapse to be:
Question 7
When a staff member asks the nurse what the thick middle
layer of the uterine wall is called, what is the nurse’s best response? The:
Question 8
Copy of The nurse would anticipate the treatment for pelvic
organ prolapse to be:
Question 9
When discussing the difference between male and female sex
hormones, which information should the nurse include? The major difference
between male and female sex hormone production is that:
Question 10
During a routine pelvic exam, a 34-year-old female is found
to have an ovarian cyst containing skin, hair, cartilage, and bone. This cyst
is classified as a _____ cyst.
Question 11
A 30-year-old male presents with penile tenderness and
discharge. Physical examination reveals that his foreskin cannot be retracted
back over the glans penis. He is suffering from:
Question 12
Which information indicates the nurse has a good
understanding of the menstrual cycle? When estrogen and progesterone levels
drop, the endometrium enters the _____ phase.
Question 13
Which of the following signs is usually the first clinical
manifestation of breast cancer?
Question 14
A nurse is discussing female anatomy. Which body structure
contains the openings to the vagina and urinary meatus?
Question 15
The patient’s medication has a side effect of gynecomastia.
The patient asks the nurse to define this term. The nurse would respond that
gynecomastia is:
Question 16
A 35-year-old female is diagnosed with endometriosis.
Suppressing which of the following would be the most appropriate medical
treatment for this disease?
Question 17
A 30-year-old female with newly diagnosed PCOS is being
counseled by her OB-GYN. The physician indicates that this condition often
results in:
Question 18
A 40-year-old female presents with cramping and excessive
vaginal bleeding. Ultrasound reveals benign uterine tumors in the smooth muscle
cells of the myometrium. These tumors are commonly called:
Question 19
When a staff member asks which structure secretes
glucose-rich fluid into the semen, how should the nurse respond?
Question 20
When the nurse describes the duct that carries the ovum from
the ovary to the uterus, what is the nurse discussing? The:
Question 21
A patient asks the nurse what is the most sensitive area of
the penis. What is the nurse’s best answer? The area of the penis with the most
nerve endings is the:
Question 22
A nurse is teaching the staff about female hormones. Which
hormone promotes the formation of channels in the mucus of the cervical os to
facilitate sperm movement into the uterus?
Question 23
A 21-year-old female is infected with human papillomavirus
(HPV) following unprotected sexual intercourse with a male she recently met.
She is now at higher risk of developing which of the following cancers?
Question 24
An 18-year-old female is diagnosed with dysmenorrhea. Which
of the following symptoms will she most likely experience?
Question 25
A 35-year-old female is diagnosed with ovarian cancer. CT
scan reveals that the cancer is limited to the ovaries. It would be classified
as stage:
Question 26
A 19-year-old female presents with genital warts. Which of
the following would cause this condition?
Question 27
When a breastfeeding mom asks what causes letdown, which
information should the nurse give the patient? The hormone that plays a role in
breast milk ejection (letdown) during lactation is:
Question 28
0 out of 1 points
The most commonly occurring cancer of the female
reproductive tract is _____ cancer.
Question 29
Copy of A 25-year-old female presents with amenorrhea and
hirsutism. She is diagnosed with PCOS. Lab testing will most likely reveal:
Question 30
A nursing student asks the nurse where the glands of
Montgomery are located. How should the nurse reply? The glands of Montgomery
are located in the:
Question 31
What term should the nurse use when discussing male sex
hormones collectively?
Question 32
_____ is inflammation of the glans penis.
Question 33
A 25-year-old female presents with amenorrhea and hirsutism.
She is diagnosed with PCOS. Lab testing will most likely reveal:
Question 34
A 56-year-old female is in menopause. She has ovarian
failure. While checking the lab results, which of the following will the nurse
find?
Question 35
An important risk factor in the development of benign
prostatic hypertrophy (BPH) is:
Question 36
A student asks the instructor which of the following
hormones stimulates follicular maturation. How should the instructor respond?
Question 37
A 35-year-old nonpregnant female presents complaining of
breast discharge. She is diagnosed with galactorrhea. The condition is most
likely caused by:
Question 38
A 21-year-old male presents with inflammation of the testes.
He has a high fever and edema and redness of the testes. Which organism is the
most likely the cause of his symptoms?
Question 39
Cryptorchidism can be defined as:
Question 40
In the majority of cases delayed puberty is due to:

walden_nurs6051_full_course_latest_2017_october.zip (1389.92 KB)

Week 1 discussion The Effects of “To Err Is Human” in Nursing Practice
The 1999 landmark study titled “To Err Is Human: Building a
Safer Health System” highlighted the unacceptably high incidence of U.S.
medical errors and put forth recommendations to improve patient safety. Since
its publication, the recommendations in “To Err Is Human’” have guided
significant changes in nursing practice in the United States.
In this Discussion, you will review these recommendations
and consider the role of health information technology in helping address
concerns presented in the report.
To prepare:
Review the summary of “To Err Is Human” presented in the
Plawecki and Amrhein article found in this week’s Learning Resources.
Consider the following statement:
“The most significant barrier to improving patient safety
identified in “To Err Is Human”is a “lack of awareness of the extent to which
errors occur daily in all health care settings and organizations (Wakefield,
2008).”
Review “The Quality Chasm Series: Implications for Nursing”
focusing on Table 3: “Simple Rules for the 21st Century Health Care System.”
Consider your current organization or one with which you are familiar. Reflect
on one of the rules where the “current rule” is still in operation in the
organization and consider another instance in which the organization has
effectively transitioned to the new rule.
By Day 3
Post your thoughts on how the development of information
technology has helped address the concerns about patient safety raised in the
“To Err Is Human” report. Summarize how informatics has assisted in improving
health care safety in your organization and areas where growth is still needed.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 2 discussion
Nursing Informatics
Competencies
Today’s fast-paced health care environment demands nurses to
be skilled not only in their clinical practice or specialty area but in the use
of technology tools that improve practice and lead to better patient care.
Basic and advanced technology competencies are required and expected as
technology increasingly touches and changes the job of every nurse. Numerous
organizations, including the American Nurses Association (ANA), the American
Medical Informatics Association (AMIA), and Healthcare Information and
Management Systems Society (HIMSS), have developed nurse-specific technology
competencies. The challenge for nurses is to identify both needs and training
opportunities.
In this Discussion, you identify the role informatics plays
in your professional responsibilities. You pinpoint personal gaps in skills and
knowledge and then develop a plan for self-improvement.
To prepare:
Review Nursing Informatics: Scope and Standards of Practice
in this week’s Learning Resources, focusing on the different functional areas
it describes. Consider which areas relate to your current nursing
responsibilities or to a position you held in the past. For this Discussion,
identify one or two of the most relevant functional areas.
Review the list of competencies recommended by the TIGER
Initiative. Identify at least one skill in each of the main areas (basic
computer competencies, information literacy competencies, and information
management competencies) that is pertinent to your functional area(s) and in
which you need to strengthen your abilities. Consider how you could improve
your skills in these areas and the resources within your organization that
might provide training and support.
By Day 3
Post the key functional area(s) of nursing informatics
relevant to your current position or to a position you recently held, and
briefly describe why this area(s) is relevant. Identify the TIGER competencies
you selected as essential to your functional area(s) in which you need
improvement. Describe why these competencies are necessary and outline a plan
for developing these competencies. Include any resources that are available to
you within your organization and the ways you might access those resources.
Assess how developing nursing informatics competencies would increase your
effectiveness as a nurse.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using the following approach: Assume the role of a consultant. Respond to
your colleagues as someone who can offer advice on improving their skills on
the competencies they identified as needing improvement.
Week 3 discussion
Standardized Coding
Systems
As a result of the fragmented nature of the health care
system, professionals in various specialty areas of medicine have developed
their own unique sets of terminology to communicate within that specialty. In
the past, limited attention has been given to codifying practices in order for
them to be understood and utilized across disciplines or through different
information technology systems. The implementation of a federally mandated
electronic medical records system, therefore, poses a challenge to nursing
professionals and others who must be prepared to utilize standardized codes for
the new system. Why are coding standards important for promoting consistent,
high-quality care?
According to Rutherford (2008, para. 15), “Improved
communication with other nurses, health care professionals, and administrators
of the institution in which nurses work is a key benefit of using a
standardized nursing language.” In this Discussion you consider the reasoning
behind and the value of standardized codification.
To prepare:
Review the information in Nursing Informatics: Scope and
Standards of Practice. Determine which set of terminologies are appropriate for
your specialty or area of expertise.
Reflect on the importance of continuity in terminology and
coding systems.
In the article, “Standardized Nursing Language: What Does It
Mean for Nursing Practice?” the author recounts a visit to a local hospital to
view its implementation of a new coding system. One of the nurses commented to
her, “We document our care using standardized nursing languages but we don’t
fully understand why we do” (Rutherford, 2008, para. 1). Consider how you would
inform this nurse (and others like her) of the importance of standardized
nursing terminologies.
Reflect on the value of using a standard language in nursing
practice. Consider if standardization can be limited to a specialty area or if
one standard language is needed across all nursing practice. Then, identify
examples of standardization in your own specialty or area of expertise. Conduct
additional research using the Walden Library that supports your thoughts on
standardization of nursing terminology.
By Day 3
Post an explanation of why nurses need to document care
using standardized nursing languages and whether this standardization can be
limited to specialty areas or if it should be across all nursing practice.
Support your response using specific examples from your own specialty or area
of expertise and using at least one additional resource from the Walden
Library.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 4 discussion
Current Information
and Communication Technologies
With so much attention focused on health care reform, it is
important that nurses be given the opportunity to use high-quality technology
tools. These tools can increase access to vital medical information, promote
effective communication among health care professionals, and improve the
patient experience. By actively seeking out and adopting these tools, nurses
can greatly enhance the quality and safety of care that they provide.
This Discussion focuses on identifying quality technology
tools that increase the ability of nurses to provide safe, effective care.
To prepare:
Review the various technology tools described in this week’s
Learning Resources.
Identify a recently adopted information, education, or
communication technology tool in your specialty area. Reflect on how it is used
and how its use impacts the quality of care.
Consider how your identified technology tool might impact
nursing practice if it were more widely used. What are some barriers preventing
increased usage? How could wider implementation be facilitated?
By Day 3
Post a description of a current or new information,
education, or communication technology tool that is being used in your
specialty area and assess its impact on the quality of care. Highlight the
effect that increased use of this technology would have on nursing practice and
discuss the barriers that are slowing or hindering its adoption. Summarize how
adoption of the technology tool could be facilitated.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 5 discussion
Electronic Health
Records
Electronic health records (EHRs) are at the center stage of
the effort to improve health care quality and control costs. In addition to
allowing medical practitioners to access and record clinical documentation at
much faster rates, EHRs are also positively influencing care delivery and
nurse-patient interaction. Yet despite the potential benefits of EHRs, their
implementation can be a formidable task that has broad-reaching implications
for an entire health care organization.
In this Discussion, you appraise strategies for obtaining
the benefits and overcoming the challenges of implementing and using electronic
health records.
To Prepare:
Review the Learning Resources focusing on the implementation
of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with
implementing EHRs. What were some positive aspects of the implementation? What
suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation
process. Were concerns handled effectively?
If you have not had any experiences with an EHR
implementation, talk to someone who has and get his or her feedback on the
experience.
Search the Walden Library for examples of effective and poor
implementation of EHRs.
By Day 3
Post an overview of at least three challenges in the
implementation of electronic health records and provide an example of each
challenge. Develop strategies for addressing each challenge based on what has
been demonstrated to be successful. Cite your resources.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 6 discussion
Successful
Implementation of Electronic Health Information Technology
Since the inception of the HITECH Act, health organizations
have faced increased pressure to update their health information technology
(HIT) resources. As discussed last week, many believe that the increased use of
electronic health records and the quick and efficient communication afforded by
HIT can lead to improved quality of patient care. Yet there are significant
costs associated with implementing such systems. What can organizations do to
ensure that the correct system is selected and that the system will be
appropriate for those required to use it? Who should be involved in those
decisions?
This week introduces the systems development life cycle and
discusses how it can guide an organization through the complexities of adopting
a new HIT system. In this Discussion, you are asked to consider the role of
nurses in the SDLC process.
To prepare:
Review the steps of the systems development life cycle.
Think about your own organization, or one with which you are
familiar, and the steps the organization goes through when purchasing and
implementing a new HIT system.
Consider what a nurse could contribute to decisions made at
each stage when planning for new health information technology. What might be
the consequences of not involving nurses?
Reflect on your own experiences with your organization
selecting and implementing new technology. As an end user, do you feel you had
any input in the selection or and planning of the new HIT system?
By Day 3
Post an analysis of
the ramifications of an organization not involving nurses in each stage of the
systems development life cycle when purchasing and implementing a new HIT
system. Give specific examples of potential issues at each stage and how the
inclusion of nurses could help avoid such issues.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 7 discussion
Understanding
Workflow Design
As you explored last week, the implementation of a new
technology can dramatically affect the workflow of an organization. Newly
implemented technologies can initially limit the productivity of users as they
adjust to their new tools. Such implementations tend to be so significant that
they often require workflows to be redesigned in order to achieve improvements
in safety and patient outcomes. However, before workflows can be redesigned,
they must first be analyzed. This analysis includes each step in completing a
certain process. Some systems duplicate efforts or contain unnecessary steps
that waste time and money and could even jeopardize patient health care. By
reviewing and modifying the workflow, you enable greater productivity. This
drive to implement new technologies has elevated the demand for nurses who can
perform workflow analysis.
In this Discussion you explore resources that have been
designed to help guide you through the process of workflow assessment.
To prepare:
Take a few minutes and peruse the information found in the
article “Workflow Assessment for Health IT Toolkit” listed in this week’s
Learning Resources.
As you check out the information located on the different
tabs, identify key concepts that you could use to improve a workflow in your
own organization and consider how you could use them.
Go the Research tab and identify and read one article that
is of interest to you and relates to your specialty area.
By Day 3
Post a summary of three different concepts you found in
“Workflow Assessment for Health IT Toolkit” that would help in redesigning a
workflow in the organization in which you work (or one with which you are
familiar) and describe how you would apply them. Next, summarize the article
you selected and assess how you could use the information to improve workflow
within your organization. Finally, evaluate the importance of monitoring the
effect of technology on workflow.
Read a selection of your colleagues’ responses. Focus
particularly on questions raised for which you can add comments based on your
experiences or situations. Consider how your colleagues’ postings reflect
and/or differ from your own perceptions and opinions. Review the Learning
Resources for any clarification needed before responding.
By Day 6
Respond to at least two of your colleagues on two different days
using one or more of the following approaches
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 8 discussion
Using Health
Information Technology as a Source of Evidence-Based Practice
Before the digital revolution, health information technology
supplied very limited support for evidence-based practice. If nurses wanted to
be informed about cutting-edge research, their best bet was to either subscribe
to leading journals or make periodic trips to the library. With the
establishment of research databases, however, nurses became empowered to learn
about and facilitate interdisciplinary and translational research. Databases
are just one example of how health information technology supports
evidence-based practice.
To prepare:
Read the following scenario from the text (McGonigle &
Mastrian, 2011, p. 482):
Twelve-hour shifts are problematic for patient and nurse
safety, and yet hospitals continue to keep the 12-hour shift schedule. In 2004,
the Institute of Medicine (Board on Health Care Services & Institute of
Medicine, 2004) published a report that referred to studies as early as 1988
that discussed the negative effects of rotating shifts on intervention accuracy.
Workers with 12-hour shifts realized more fatigue than workers on 8-hour
shifts. In another study done in Turkey by Ilhan, Durukan, Aras, Turkcuoglu,
and Aygun (2006), factors relating to increased risk for injury were age of 24
or less, less than 4 years of nursing experience, working in the surgical
intensive care units, and working for more than 8 hours.
Consider how the resources identified in the scenario above
could influence an organization’s practice.
Select an issue in your practice that is of concern to you.
Using health information technology, locate at least three evidence-based
practice resources that address your concern and that could possibly inform
further action.
By Day 3
Post a description of your practice concern. Outline how you
used health information technology to locate evidence-based practices that
address this concern. Cite and include insights from the resources. Analyze how
health information technology supports evidence-based practice.
Read a selection of your colleagues’ responses. Focus
particularly on those questions raised to which you can add comments based on
shared experiences or situations. Consider how your colleagues’ postings
reflect and/or differ from your own perceptions and opinions. Review the
Learning Resources for any clarification needed before responding.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 9 discussion
HITECH Legislation
In order for organizations to receive the incentives offered
through the HITECH legislation, they must be able to demonstrate that they are
using the technology in meaningful ways. The following criteria for meaningful
use must be evident to qualify for EHR incentives (U.S. Department of Health
& Human Services, 2012). The technology must:
Improve quality, safety, and efficiency, and reduce health
disparities
Engage patients and families
Improve care coordination
Improve population and public health
Ensure adequate privacy and security protections for
personal health information
For this Discussion you consider the impact of the
meaningful use criteria of the HITECH legislation on the adoption of health
information technology.
To prepare:
Review the Learning Resources on the HITECH legislation and
its primary goals.
Reflect on the positive and negative impact this legislation
has had on your organization or one with which you are familiar.
Consider the incentives to encourage the use of EHRs. Focus
on the definition of meaningful use and how it is measured.
Reflect on how the incentives and meaningful use impact the
quality of patient care.
Find an article in the Walden Library dealing with one of
the criteria to qualify for meaningful use and how it has been successfully
met.
By Day 3
Post a description of how HITECH legislation has positively
or negatively impacted your organization. Address how its related incentives
influence the adoption of health information technology in health care and
impact the quality of patient care. Provide a summary of the article you
identified and explain how it demonstrates the ability of health information
technology to meet the requirements of meaningful use.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional background
information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 10 discussion
Security of Health
Care Records
With the increase of health information technology used to
store and access patient information, the likelihood of security breaches has
also risen. In fact, according to the Canadian Medical Association Journal
(CMAJ):
In the United States, there was a whopping 97% increase in
the number of health records breached from 2010 to 2011… The number of patient
records accessed in each breach has also increased substantially, from 26,968
(in 2010) to 49,394 (in 2011). Since August 2009, when the US government
regulated that any breach affecting more than 500 patients be publicly
disclosed, a total of 385 breaches, involving more than 19 million records,
have been reported to the Department of Health and Human Services.
A large portion of those breaches, 39%, occurred because of
a lost, stolen, or otherwise compromised portable electronic device—a problem
that will likely only get worse as iPads, smartphones, and other gadgets become
more common in hospitals. (CMAJ, 2012, p. E215).
Consider your own experiences. Does your organization use
portable electronic devices? What safeguards are in place to ensure the
security of data and patient information? For this Discussion you consider
ethical and security issues surrounding the protection of digital health
information.
To prepare:
Review the Learning Resources dealing with the security of
digital health care information. Reflect on your own organization or one with
which you are familiar, and think about how health information stored
electronically is protected.
Consider the nurse’s responsibility to ensure the protection
of patient information. What strategies can you use?
Reflect on ethical issues that are likely to arise with the
increased access to newer, smaller, and more powerful technology tools.
Consider strategies that can be implemented to ensure that
the use of HIT contributes to an overall culture of safety.
By Day 3
Post an analysis of the nurse’s responsibility to protect
patient information and the extent that HIT has made it easier or more
difficult to protect patient privacy. Comment on any security or ethical issues
related to the use of portable devices to store information. Assess the
strategies your organization uses to safeguard patient information and how
these promote a culture of safety. Describe an area where improvement is needed
and one strategy that could address the situation.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 11 discussion
Health Literacy
In order to effectively manage their own health, individuals
need to have competencies in two areas—basic literacy and basic health
literacy. What is the difference? Basic literacy refers to the ability to read,
even simple language. Health literacy is defined as, “the degree to which
individuals have the capacity to obtain, process, and understand basic health
information and services needed to make appropriate health decisions” (National
Coalition for Literacy, 2009). Unfortunately, according to a Department of
Education report on health literacy, only 12% of adults aged 16 and older are
considered to have a proficient level of health literacy (U.S. Department of
Education, 2006). Acquiring health literacy skills has become more complicated
with the explosion of online health information, some credible and some
misleading.
In this Discussion, you focus on how to help individuals
find credible information on the Internet and develop strategies nurses can use
to increase the health literacy of their patients.
To prepare:
Think about the nurse’s role in improving the health
literacy of patients.
Consider the many ways patients access health information,
including blogs, social media, patient portals, websites, etc.
Reflect on experiences you have had with patients who
self-diagnose using online medical sources.
Using the Internet, the Walden Library, or other trustworthy
sources, identify a resource that you could introduce to patients to help them
evaluate the credibility of health information found online.
What are some strategies you could employ to improve the
health literacy of patients?
By Day 3
Post your assessment of the nurse’s role in improving the
health literacy of patients. Then, identify the resource you would recommend to
patients for evaluating online health information and why it would be
beneficial. Describe additional strategies for assisting patients in becoming
informed consumers of online health information.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different
days using one or more of the following approaches:
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.
Week 4 assignment
Using the
Data/Information/Knowledge/Wisdom Continuum
Have you ever gone online to search for a journal article on
a specific topic? It is amazing to see the large number of journals that are
available in the health care field. When you view the library in its entirety,
you are viewing untapped data. Until you actually research for your particular
topic, there is little structure. Once you have narrowed it down, you have
information and once you apply the information, you have knowledge. Eventually,
after thoughtful research and diligent practice, you reach the level of
wisdom—knowledge applied in meaningful ways.
Are there areas in your practice that you believe should be
more fully explored? The central aims of nursing informatics are to manage and
communicate data, information, knowledge, and wisdom. This continuum represents
the overarching structure of nursing informatics. In this Assignment, you
develop a research question relevant to your practice area and relate how you
would work through the progression from data to information, knowledge, and
wisdom.
To prepare:
Review the information in Figure 6–2 in Nursing Informatics
and the Foundation of Knowledge.
Develop a clinical question related to your area of practice
that you would like to explore.
Consider what you currently know about this topic. What
additional information would you need to answer the question?
Using the continuum of data, information, knowledge, and
wisdom, determine how you would go about researching your question.
Explore the available databases in the Walden Library.
Identify which of these databases you would use to find the information or data
you need.
Once you have identified useful databases, how would you go
about finding the most relevant articles and information?
Consider how you would extract the relevant information from
the articles.
How would you take the information and organize it in a way
that was useful? How could you take the step from simply having useful
knowledge to gaining wisdom?
By Day 7 of Week 4
Write a 3- to 4-page paper that addresses the following:
Summarize the question you developed, and then relate how
you would work through the four steps of the data, information, knowledge,
wisdom continuum. Be specific.
Identify the databases and search words you would use.
Relate how you would take the information gleaned and turn
it into useable knowledge.
Can informatics be used to gain wisdom? Describe how you
would progress from simply having useful knowledge to the wisdom to make
decisions about the information you have found during your database search.
Your paper must also include a title page, an introduction,
a summary, and a reference page
Week 6 assignment
Assignment:
Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or
failure of the adoption of EHRs. It is important for nurses to understand their
role as change agents and the ways they can influence others when addressing
the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of
innovations, identified five qualities that determine individual attitudes
towards adopting new technology (2003). He theorized that individuals are
concerned with:
Relative advantage: The individual adopting the new
innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The
adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily
master the new technology; the more difficult learning the new system appears,
the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to
“play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the
proposed innovation has been successful in other situations.
Note: You are not required to purchase Rogers’ book or
pursue further information regarding his list of five qualities. The
information provided here is sufficient to complete this Assignment. The full
reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse
facilitator in a small hospital in upstate New York. You have been part of a
team preparing for the implementation of a new electronic health records
system. Decisions as to the program that will be used have been finalized, and
you are now tasked with preparing the nurses for the new system. There has been
an undercurrent of resistance expressed by nurses, and you must respond to their
concerns. You have a meeting scheduled with the nurses 1 week prior to the
training on the new EHR system. Consider how you can use the five qualities
outlined by Rogers (2003) to assist in preparing the nurses for the upcoming
implementation.
To prepare
Review the Learning Resources this week about successful
implementations of EHRs.
Consider how you would present the new EHR system to the
nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would
addressing each of those areas improve the likelihood of success?
By Day 7 of Week 6
Write a 3- to 5-page paper which includes the following:
Using Rogers’ (2003) theory as a foundation, outline how you
would approach the meeting with the nurses. Be specific as to the types of information
or activities you could provide to address each area and include how you would
respond to resistance.
Analyze the role of nurses as change agents in facilitating
the adoption of new technology.
Week 8 assignment
Assignment: Creating
a Flowchart
Workflow analysis aims to determine workflow patterns that
maximize the effective use of resources and minimize activities that do not add
value. There are a variety of tools that can be used to analyze the workflow of
processes and clarify potential avenues for eliminating waste. Flowcharts are a
basic and commonly used workflow analysis method that can help highlight areas
in need of streamlining.
In this Assignment, you select a common event that occurs
regularly in your organization and create a flowchart representing the
workflow. You analyze the process you have diagrammed and propose changes for
improvement.
To prepare:
Identify a common, simple event that frequently occurs in
your organization that you would like to evaluate.
Consider how you would design a flowchart to represent the
current workflow.
Consider what metrics you would use to determine the
effectiveness of the current workflow and identify areas of waste.
To complete:
Write a 3- to 5-page paper which includes the following:
Create a simple flowchart of the activity you selected.
(Review the Sample Workflow of Answering a Telephone in an Office document
found in this week’s Learning Resources for an example.)
Next, in your paper:
Explain the process you have diagrammed.
For each step or decision point in the process, identify the
following:
Who does this step? (It can be several people.)
What technology is used?
What policies and rules are involved in determining how,
when, why, or where the step is executed?
What information is needed for the execution of this step?
Describe the metric that is currently used to measure the
soundness of the workflow. Is it effective?
Describe any areas where improvements could occur and
propose changes that could bring about these improvements in the workflow.
Summarize why it is important to be aware of the flow of an
activity.
Remember to include a cover page, introduction, and summary
for your paper
Week 11 assignment
Assignment: Health
Information Patient Handout
One of the pivotal goals of consumer health literacy efforts
is to design educational materials that attract as well as educate users. In
this Assignment, you design a health information document on a topic that is of
interest to you.
To prepare:
Select a health issue of interest to you.
Identify the audience or population that you seek to educate
about this issue.
Search the Internet to find credible sites containing
information about your selected topic.
Review the two health literacy websites listed in this
week’s Learning Resources. Focus on strategies for presenting information.
To complete:
Design an educational handout on the health issue you
selected.
Include a cover page.
Include an introduction that provides:
An explanation of your issue and why you selected it
A description of the audience you are addressing
In the handout itself:
Develop your handout in such a way that it attracts the
attention of the intended audience.
Include a description of the health issue and additional
content that will enhance your message (i.e., key terms and definitions,
graphics, illustrations, etc.).
Recommend four or five sites that provide clear, valuable,
and reliable information on the topic.
Note: Remember to keep the information in your health
handout and its design at the appropriate level for the audience you are
seeking to inform. Submit your Assignment as a Word document.
By Day 5
Submit the Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading,
do the following:
Please save your Assignment using the naming convention
“WK11Assgn+last name+first initial.(extension)” as the name.
Click the Week 11 Assignment Rubric to review the Grading
Criteria for the Assignment.
Click the Week 11 Assignment link. You will also be able to
“View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My
Computer button. Find the document you saved as “WK11Assgn+last name+first
initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox
for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

walden_nurs6051_all_week_assignments_latest_2017_october.zip (428.87 KB)

Week 4 assignment Using the Data/Information/Knowledge/Wisdom Continuum
Have you ever gone online to search for a journal article on
a specific topic? It is amazing to see the large number of journals that are
available in the health care field. When you view the library in its entirety,
you are viewing untapped data. Until you actually research for your particular
topic, there is little structure. Once you have narrowed it down, you have
information and once you apply the information, you have knowledge. Eventually,
after thoughtful research and diligent practice, you reach the level of
wisdom—knowledge applied in meaningful ways.
Are there areas in your practice that you believe should be
more fully explored? The central aims of nursing informatics are to manage and
communicate data, information, knowledge, and wisdom. This continuum represents
the overarching structure of nursing informatics. In this Assignment, you
develop a research question relevant to your practice area and relate how you
would work through the progression from data to information, knowledge, and
wisdom.
To prepare:
Review the information in Figure 6–2 in Nursing Informatics
and the Foundation of Knowledge.
Develop a clinical question related to your area of practice
that you would like to explore.
Consider what you currently know about this topic. What
additional information would you need to answer the question?
Using the continuum of data, information, knowledge, and
wisdom, determine how you would go about researching your question.
Explore the available databases in the Walden Library.
Identify which of these databases you would use to find the information or data
you need.
Once you have identified useful databases, how would you go
about finding the most relevant articles and information?
Consider how you would extract the relevant information from
the articles.
How would you take the information and organize it in a way
that was useful? How could you take the step from simply having useful
knowledge to gaining wisdom?
By Day 7 of Week 4
Write a 3- to 4-page paper that addresses the following:
Summarize the question you developed, and then relate how
you would work through the four steps of the data, information, knowledge,
wisdom continuum. Be specific.
Identify the databases and search words you would use.
Relate how you would take the information gleaned and turn
it into useable knowledge.
Can informatics be used to gain wisdom? Describe how you
would progress from simply having useful knowledge to the wisdom to make
decisions about the information you have found during your database search.
Your paper must also include a title page, an introduction,
a summary, and a reference page
Week 6 assignment
Assignment:
Application: Adoption of New Technology Systems
As a nurse, you can have a great impact on the success or
failure of the adoption of EHRs. It is important for nurses to understand their
role as change agents and the ways they can influence others when addressing
the challenges of changing to a drastically different way of doing things.
Everett Rogers, a pioneer in the field of the diffusion of
innovations, identified five qualities that determine individual attitudes
towards adopting new technology (2003). He theorized that individuals are
concerned with:
Relative advantage: The individual adopting the new
innovation must see how it will be an improvement over the old way of doing things.
Compatibility with existing values and practices: The
adopter must understand how the new innovation aligns with current practices.
Simplicity: The adopter must believe he or she can easily
master the new technology; the more difficult learning the new system appears,
the greater the resistance that will occur.
Trialability: The adopter should have the opportunity to
“play around’ with the new technology and explore its capabilities.
Observable results: The adopter must have evidence that the
proposed innovation has been successful in other situations.
Note: You are not required to purchase Rogers’ book or
pursue further information regarding his list of five qualities. The
information provided here is sufficient to complete this Assignment. The full
reference for Rogers’ work is provided below the due date on this page.
For this Assignment, you assume the role of a nurse
facilitator in a small hospital in upstate New York. You have been part of a
team preparing for the implementation of a new electronic health records
system. Decisions as to the program that will be used have been finalized, and
you are now tasked with preparing the nurses for the new system. There has been
an undercurrent of resistance expressed by nurses, and you must respond to their
concerns. You have a meeting scheduled with the nurses 1 week prior to the
training on the new EHR system. Consider how you can use the five qualities
outlined by Rogers (2003) to assist in preparing the nurses for the upcoming
implementation.
To prepare
Review the Learning Resources this week about successful
implementations of EHRs.
Consider how you would present the new EHR system to the
nurses to win their approval.
Reflect on the five qualities outlined by Rogers. How would
addressing each of those areas improve the likelihood of success?
By Day 7 of Week 6
Write a 3- to 5-page paper which includes the following:
Using Rogers’ (2003) theory as a foundation, outline how you
would approach the meeting with the nurses. Be specific as to the types of information
or activities you could provide to address each area and include how you would
respond to resistance.
Analyze the role of nurses as change agents in facilitating
the adoption of new technology.
Week 8 assignment
Assignment: Creating
a Flowchart
Workflow analysis aims to determine workflow patterns that
maximize the effective use of resources and minimize activities that do not add
value. There are a variety of tools that can be used to analyze the workflow of
processes and clarify potential avenues for eliminating waste. Flowcharts are a
basic and commonly used workflow analysis method that can help highlight areas
in need of streamlining.
In this Assignment, you select a common event that occurs
regularly in your organization and create a flowchart representing the
workflow. You analyze the process you have diagrammed and propose changes for
improvement.
To prepare:
Identify a common, simple event that frequently occurs in
your organization that you would like to evaluate.
Consider how you would design a flowchart to represent the
current workflow.
Consider what metrics you would use to determine the
effectiveness of the current workflow and identify areas of waste.
To complete:
Write a 3- to 5-page paper which includes the following:
Create a simple flowchart of the activity you selected.
(Review the Sample Workflow of Answering a Telephone in an Office document
found in this week’s Learning Resources for an example.)
Next, in your paper:
Explain the process you have diagrammed.
For each step or decision point in the process, identify the
following:
Who does this step? (It can be several people.)
What technology is used?
What policies and rules are involved in determining how,
when, why, or where the step is executed?
What information is needed for the execution of this step?
Describe the metric that is currently used to measure the
soundness of the workflow. Is it effective?
Describe any areas where improvements could occur and
propose changes that could bring about these improvements in the workflow.
Summarize why it is important to be aware of the flow of an
activity.
Remember to include a cover page, introduction, and summary
for your paper
Week 11 assignment
Assignment: Health
Information Patient Handout
One of the pivotal goals of consumer health literacy efforts
is to design educational materials that attract as well as educate users. In
this Assignment, you design a health information document on a topic that is of
interest to you.
To prepare:
Select a health issue of interest to you.
Identify the audience or population that you seek to educate
about this issue.
Search the Internet to find credible sites containing
information about your selected topic.
Review the two health literacy websites listed in this
week’s Learning Resources. Focus on strategies for presenting information.
To complete:
Design an educational handout on the health issue you
selected.
Include a cover page.
Include an introduction that provides:
An explanation of your issue and why you selected it
A description of the audience you are addressing
In the handout itself:
Develop your handout in such a way that it attracts the
attention of the intended audience.
Include a description of the health issue and additional
content that will enhance your message (i.e., key terms and definitions,
graphics, illustrations, etc.).
Recommend four or five sites that provide clear, valuable,
and reliable information on the topic.
Note: Remember to keep the information in your health
handout and its design at the appropriate level for the audience you are
seeking to inform. Submit your Assignment as a Word document.
By Day 5
Submit the Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading,
do the following:
Please save your Assignment using the naming convention
“WK11Assgn+last name+first initial.(extension)” as the name.
Click the Week 11 Assignment Rubric to review the Grading
Criteria for the Assignment.
Click the Week 11 Assignment link. You will also be able to
“View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My
Computer button. Find the document you saved as “WK11Assgn+last name+first
initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox
for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

walden_nurs6051_week_7_discussion_latest_2017_october_.docx (89.84 KB)

Week 7 discussion Understanding Workflow Design
As you explored last week, the implementation of a new
technology can dramatically affect the workflow of an organization. Newly
implemented technologies can initially limit the productivity of users as they
adjust to their new tools. Such implementations tend to be so significant that
they often require workflows to be redesigned in order to achieve improvements
in safety and patient outcomes. However, before workflows can be redesigned,
they must first be analyzed. This analysis includes each step in completing a
certain process. Some systems duplicate efforts or contain unnecessary steps
that waste time and money and could even jeopardize patient health care. By
reviewing and modifying the workflow, you enable greater productivity. This
drive to implement new technologies has elevated the demand for nurses who can
perform workflow analysis.
In this Discussion you explore resources that have been
designed to help guide you through the process of workflow assessment.
To prepare:
Take a few minutes and peruse the information found in the
article “Workflow Assessment for Health IT Toolkit” listed in this week’s
Learning Resources.
As you check out the information located on the different
tabs, identify key concepts that you could use to improve a workflow in your
own organization and consider how you could use them.
Go the Research tab and identify and read one article that
is of interest to you and relates to your specialty area.
By Day 3
Post a summary of three different concepts you found in
“Workflow Assessment for Health IT Toolkit” that would help in redesigning a
workflow in the organization in which you work (or one with which you are
familiar) and describe how you would apply them. Next, summarize the article
you selected and assess how you could use the information to improve workflow
within your organization. Finally, evaluate the importance of monitoring the
effect of technology on workflow.
Read a selection of your colleagues’ responses. Focus
particularly on questions raised for which you can add comments based on your
experiences or situations. Consider how your colleagues’ postings reflect
and/or differ from your own perceptions and opinions. Review the Learning
Resources for any clarification needed before responding.
By Day 6
Respond to at least two of your colleagues on two different days
using one or more of the following approaches
Ask a probing question, substantiated with additional
background information, evidence or research.
Share an insight from having read your colleagues’ postings,
synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings
from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional
research.
Make a suggestion based on additional evidence drawn from
readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional
insights or contrasting perspectives based on readings and evidence.