Monthly Archives: May 2023

Formulate one new comment of your own. It must be a logical and thoughtful response that synthesizes the comments of at least 3 classmates into one comment. Be sure to synthesize; do not simply reply to each of the 3 classmates.

1. Pan American Health Organization (PAHO) is an important health organization in the United States. PAHO was created in December 1902, consisting of the United States, Latin American and Caribbean countries. The PAHO was created as a response to the yellow fever outbreak that originated in Latin America and spread to the United States. As of today, the PAHO along with the World Health Organization (WHO), has provided surveillance and support health care services to help with COVID-19 (PAHO 2020). The organization has provided evidence-based documents and strategies to help manage COVID-19 in surrounding areas. PAHO continues to research COVID-19 and other diseases to ensure safety to the public. One of PAHO’s future agendas is to improve national policies and resources to address the shortage of healthcare workers and the distribution of resources to hospitals (PAHO 2020). Research shows that the health field needs approximately 800,000 healthcare works to achieve essential health needs (PAHO 2020). To reach this goal the organization has developed three points of action, which include improving leadership and governance for human health resources, expanding access to health and health coverage, and partnering with education specialist to respond to the needs of health systems (PAHO 2020). 

References

PAHO. (2020). COVID-19 Situation Reports. Retrieved October 08, 2020, from https://www.paho.org/en/covid-19-situation-reports

PAHO. (2020). PAHO/WHO: Pan American Health Organization. Retrieved October 07, 2020, from https://www.paho.org/hq/index.php?option=com_content

Timia Collins 

2.  Lately, we all look at the global outbreak of coronavirus and its effects worldwide. One of the crises that I would like to make aware of is the crisis of drug resistance antibiotics and its effects in other countries and the United States.  Bacterial infections have affected and killed patients due to wounds, urinary tract infections, bloodstream infections, and even ventilators’ infections.  The Global Antibiotic Research Development Partnership (GARDP)  is a non- global profit organization that helps create medication therapy that will treat infections that are “drug-resistance” that could pose as life-threatening to the patients’ health.  The goal is to develop modern antibiotics that will treat life-threatening diseases and are non-resistant.  GARDP was formed by the World Health Organization (WHO) and is one of the few organizations that the WHO has helped formed to combat the need to develop medication for disease worldwide. (About GARDP 2020) deaths due to drug resistance are estimated at 700,000 a year, and that children and infants die with curable illness. (About GARDP 2020) notes that the rise in deaths due to ineffective drugs has made this a global crisis to the World Health Organization. 

About GARDP – Global Antibiotic Research and Development Partnership. GARDP. (2020, May 18). https://gardp.org/who-we-are/about-gardp/.

Sandra

3. The World Health Organization (WHO) is a worldwide organization that promotes health, keeps the world safe, and especially serves the vulnerable. When dealing with health emergencies and disease outbreaks, the WHO identifies, mitigates, and manages risks, responds to health emergencies, and prevents emergencies by developing necessary tools for outbreaks (World Health Organization, n.d.). 

Influenza diseases, the most common viruses, are ever-evolving worldwide. In fact, “in the United States, influenza results in approximately 200,000 hospitalizations and 36,000 deaths in a typical endemic season,” according to Taubenberger & Morens (2011, para 2). The WHO consults with groups of advisers to evaluate influenza data a couple of times a year. This data is useful for creating vaccines to treat the influenza virus around the globe. The organization can analyze the virus’s characteristics and compare countries with others based on the spread of infection. As stated by the World Health Organization (2020), “representatives from WHO Collaborating Centres for influenza (CCs) of GISRS” and “representatives from WHO Essential Regulatory Laboratories (ERLs) of GISRS” participate in constructing influenza vaccine by 2021. The WHO prioritizes their values and vision of a world where people obtain the highest level of health in a collective effort to keep the world safe. 

References: 

Taubenberger, J. K., & Morens, D. M. (2008). The pathology of influenza virus infections. Annual review of pathology, 3, 499–522. https://doi.org/10.1146/annurev.pathmechdis.3.121806.154316

World Health Organization. (n.d.). What we do. Retrieved October 05, 2020, from https://www.who.int/about/what-we-do

World Health Organization. (2020, September 29). WHO Consultation and Information Meeting on the Composition of Influenza Virus Vaccines for Use in the 2021 Southern Hemisphere Influenza Season. Retrieved October 05, 2020, from https://www.who.int/influenza/vaccines/virus/recommendations/consultation202009/en/

Kaylee

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance

1. Choose one of the numerous partners involved in global health (clinical care providers, governmental agencies, private foundations, corporations, intergovernmental groups, public-private partnerships, nonprofit organizations, the defense sector, universites, the media, and many others. 
2. Select a health related topic for which you want to advocate for. Request help from the agency/ entity of your choice in order to help the problem at hand.  Example: Request Apple to donate $1.00 for every iPhone they sell to provide clean water for the community in Bangladesh.
3. Create a 5 to 10 slide PowerPoint presentation to deliver your message to the agency/ entity of your choice about the health related issue you want help with. 
4. Your slides should:
   • first slide (after title slide) should explain at least three (3) objectives of your request.
   • clearly state purpose of request to agency/ entity. 
   • show relevant and up to date statistic on the problem you are trying to advocate for. (include references)
   • use references according to the APA Style Guide.
   • be original work, and will be checked for plagiarism.

Watch the first 7 minutes from Charged with Manslaughter for a Drug Error.

After reflecting on the video content and reviewing the information in this module, discuss how you, as a nurse, will balance the ethical obligations you have to the patient for safe medication administration with the pressures and policies of healthcare institutions and your nursing workload. Develop a plan on how you will prevent yourself from becoming lax and using shortcuts in the medication administration process.

Assignment:

Motivations & Emotions

This is an essay that will include images.

• Select one theory related to motivation and emotions and summarize it.
• Choose an open source or creative commons image from the internet and explain how it demonstrates how both gestures and emotions are understood inter- and intra- culturally (be sure to cite the source of the image).  
• Explain how cultural and situational factors can impact an individual’s eating habits and taste preferences. Provide at least one example.
• Analyze how stress impacts health (include the three main types of stressors) and provide at least one recommendation for each type of stressor to reduce stress and improve health.

Assignment Expectations

Length: 1250-1750 words; answers must thoroughly address the questions in a clear, concise manner.

Structure: Include a title and reference page in APA style. These do not count towards the minimal word amount for this assignment.

References: Use the appropriate APA style, in text citations, and references for all resources utilized to answer the questions. Include at least three scholarly citations to support your claims.

Research paper of Human Growth and Development, Chapter 2- Module 2.2. This project has to be done in APA style and it will be evaluated in Turnitin. Due day 11/22/2020. I attached two power points with summaries and photos from the book. 

Reply separately to two of your classmates Powerpoint / video posts (See both attached classmates Powerpoint, PP#1 Narrative therapy, and PP#2 Feminist Therapy). 

Here is a great video explaining what a Feminist therapy is and how it is used.                                              An Overview of Feminist Therapy
https://youtu.be/H3Bx6cWXZBY

Here is a great video explaining what Narrative therapy is and how it is used.
Grande, T. (2018, February 20). What is narrative therapy? [Video]. YouTube. https://www.youtube.com/watch?v=GoMfpmTJ28c&feature=emb_logo

INSTRUCTIONS:

Your responses should be in a well-developed paragraph (300-350 words) to each peer. Integrating an evidence-based resource!

Note: DO NOT CRITIQUE THEIR POSTS, DO NOT AGREE OR DISAGREE, just add informative content regarding to their topic that is validated via citations. 

– Utilize at least two scholarly references per peer post. 

Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.

– Minimum of 300 words per peer reply.

– TURNITIN Assignment.

Background: I live in South Florida, I am currently enrolled in the Psych Mental Health Practitioner Program, I am a Registered Nurse, I work in a Psychiatric Hospital.

  How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow?Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat.This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors. 

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier. Chapter 1, “Prescriptive Authority” (pp. 1–3) Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7) Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12) Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33) Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42) Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767 American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center. This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html This website details key aspects of drug registration.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples. At least 2 citations APA format 7th editionFUOne patient case from my experience that addresses the principles of pharmacokinetics and pharmacodynamics is where my patient was a 55 years old female, of African American decent, had a history of diabetes, hyperlipidemia, and hypertension. The patient was presented to our hospital with severe nausea, vomiting and abdominal pain. Assessment and lab work showed the patient’s blood glucose was 605mg/dL, HgA1C 8.5%, cholesterol 180 mg/dl, weight 290 lbs, height 68inches, BP 90/75, pulse 118, Respiration 23 bpm. Patient stated she had been very stressed lately and had mostly been dining out at fast-food restaurants and has not had the time to exercise. Patient had been prescribed insulin however, she stated she has not been checking her blood glucose level like she should have. This patient was presenting with symptoms of diabetic ketoacidosis (DKA). DKA is a medical emergency that occurs when the body is unable to produce adequate insulin to decrease blood glucose level and leads to the production of high levels of acids in the blood called ketones (Alshammari et. al., 2017). This was a medical emergency that required immediate intervention of fluid repletion and the administration of insulin. It also involved the frequent monitoring of patient’s vital signs, glucose levels, and electrolyte levels. Factors that might have influenced pharmacokinetics of insulin the patient was receiving are diet (eating fatty foods or foods high in carbohydrates increases glucose levels in the body), stress (cortisol increases insulin resistance), and lack of exercise. Eating a balanced diet decreases the likelihood that the patient will consume mostly foods high in fats and carbohydrates. When someone is stressed, the body produces stress hormones called cortisol which to a diabetic patient can significantly affect their health because it causes the body to release more glucose and to become resistant to the insulin the patient needs to reduce that blood glucose to a healthy level (Alshammari et. al., 2017). Exercise redistributes and lowers the blood glucose level. It could cause patients to go into hypoglycemia that is why it is important to check glucose levels before, during, and after exercise.The personalized care plan that I would develop for this patient would include; a Dietary and lifestyle change plan – here the patient will be educated on how to count her carbohydrates and caloric intake. The Center for Disease Control has dietary guidelines for the different age groups. The site also provides “My Food Diary” (CDC, 2019) a flow sheet to help individuals keep a day-to-day record of how much food is consumed for breakfast, snacks, lunch, and dinner. I would also recommend she exercise regularly but that to check her blood glucose before, during and after exercise. “The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes” (Colberg, 2016). Also, I would suggest she check her blood glucose before each insulin administration, as this may affect the dosage to be administered.

ReferencesAlshammari, A. A., Alahdal, L. M., Jawi, J. T., Alnofaie, H. A., Aldossari, N. A., AbdulazizAlassaf, H. M., Ramel, A. I., Almshikhess, S. H., Felemban, A. S., Alanazi, S. A., Joharji, R. N., Alzahrani, A. M. B., Almaghamsi, S. A. D., Alalawi, M. S. M., Alasmari, H. I., Abduljabbar, A. M., & alzahrani, A. fahad. (2017).

 First Line Management of Adult Diabetic Ketoacidosis Patients. Egyptian Journal of Hospital Medicine, 67(2), 571–577. https://doi-org.ezp.waldenulibrary.org/10.12816/0037808

Centers fo Disease Control and Prevention [CDC], 2019. Eating Out. Retrieved from https://www.cdc.gov/diabetes/managing/eat-well.htmlColberg, S.R., Sigal, R. J., Yardley, J. E., Riddle, M.C., Dunstan, D.W., Dempsey, P.C., … & Tate, D.F. (2016). 

Physical activities/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes care, 39(11), 2065-2079 

role of a practicing nurse

I need a response for the following peer

Breast Lump Case Study

The case involves a 37-year-old woman, gravida 2 para 2, who presents to the clinic with a chief complaint of a lump in her left breast. Her family is positive for breast cancer. Both children, aged 9 and 7, are alive and delivered without complications. She has a healthy weight (BMI 22), and does not smoke, but drink a glass of wine most evening with supper. She has regular physicals and is up to date with smears. A physical examination revealed a firm lump near the surface with no masses. The lump was aspirated, removing an opaque liquid. The aspiration vanished the lump. 

The most probable diagnosis is a breast cyst. Cysts are formed by the accumulation of fluid inside the breast glands. A majority of cystic lesions are benign while the majority of solid lesions are malignant. Most breast cysts are small (5 mm to 20 mm) and painless. They are strongly influenced by hormones and are common in women of childbearing age. While a breast cyst is palpable, it can be confused with a solid mass. Therefore, one of the fundamental approaches is a fine-needle aspiration biopsy. The aspirated fluid does not contain blood or other cystic components. However, if it contained blood, it would have been critical to send the fluid for cytology and consultation from a surgeon. 

Further evaluation of the breast lump or mass is guided by findings on history, physical examination, imaging, and biopsy. In this case, a triple test of clinical breast exam, ultrasonography, and needle biopsy may be necessary to find a definitive diagnosis. Based on the extent of clinical suspicion, the practitioner should order mammography before a pathologic diagnosis. Mammography is essential in the evaluation of palpable lesions. However, if the lump is suggestive of a fibroadenoma by ultrasound and mammography, short-term follow-up and re-imaging are essential. Fibrocystic changes present on a mammogram as round or oval, well-defined masses. A biopsy is also necessary to identify whether the cysts are malign. Complex cysts with both fluid and solid matter necessitate biopsy (Brown, Phillips, Slanetz, Fein-Zachary, Venkataraman, Dialani & Mehta, 2017). The fine needle aspiration provides sufficient cellular material to facilitate adequate cytologic evaluation. However, core biopsy is recommended because it uses a large cutting needle that allows the collection of tissues suitable for histologic analysis that is familiar to most pathologists. 

Breast cysts do not increase the risk of breast cancer. According to Lin, Peng, and He (2018), cysts, including complex cysts have a low risk of breast cancer. However, benign breast diseases (BBD) are not life-threatening, some may increase the risk of breast cancer. Cysts are classified as non-proliferative disorder and their absolute risk of causing cancer is estimated to be 2% (Stachs, Stubert, Reimer & Hartmann, 2019). Etiologically, cysts are associated with fibrocystic changes. More than 50% of women develop symptomatic fibrocystic changes in their lifetime. Fibrocystic changes are caused by hormonal changes and are common in women between 20 and 59 years. Breast cancer risk factors are numerous and diverse, including age (65 years and above), atypical hyperplasia, history of early-onset breast cancer, high postmenopausal endogenous estrogen, and high-dose radiation to the chest. 

However, it is important to consider her family history of breast cancer. A hereditary predisposition to breast cancer increases the risk of developing breast cancer at a younger age. Therefore, early identification of patients with a hereditary predisposition is vital to exploit the numerous opportunities provided by enhanced surveillance, chemoprevention, and risk-reducing surgery. Patient can be counseled on breast self-examination and a follow-up schedule established. Follow-up is critical in detecting missed cancer. During the follow-up, it is fundamental to evaluate recurrent masses or fluid.