Monthly Archives: May 2023

Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session.

Then, address in your Practicum Journal the following:

• Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session.
• Describe (without violating HIPAA regulations) each client, and identify any pertinent history or medical information, including prescribed medications.
• Using the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5), explain and justify your diagnosis for each client.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

 ATI RN Fundamentals Proctored Focus Can an RN delegate to the LPN to provide tracheostomy care to a client with pneumonia? A nurse on a med-surg unit has received change-of-shift report & will care for 4 clients. Which of the following client’s needs may the nurse assign to a assistive personnel (AP)? A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP? Select All. An RN is making assignments for client care to a LPN at the beginning of the shift. Which of the following assignments should the LPN question? A nurse is preparing an in-service program about delegation. Which of the following elements should she identify when presenting the 5 rights of delegation? Select all. A nurse manager of a med-surg unit is assigning care responsibilities for the oncoming shift. A client is awaiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign to this client? A nurse observes an AP reprimanding a client for not using the urinal properly. The AP tells him she will put a diaper on him if he does not use the urinal more carefully next time. Which of the following torts is the AP committing? An adult client who is competent tells the nurse that he is thinking about leaving the hospital against medical advice. The nurse believes that this is not in the client’s best interest, so she administers a PRN sedative med that the client has not requested along w/his usual meds. Which of the following tort has the nurse committed? A client who will undergo neurosurgery the following week tells the nurse in the surgeon’s office that he will prepare his advance directives before he goes to the hospital. Which of the following statements by the client indicates to the nurse that he understands advance directives? A client is about to undergo an elective surgical procedure. Which of the following actions are appropriate for the nurse who is providing pre-op care regarding informed consent? Select all. A nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy & unable to focus on the issue at hand. Today, she found the nurse asleep in a chair in the break room when she was not on break. Which of the following actions should the nurse take? A nurse is preparing info for a change-of-shift report. Which of the following info should the nurse include in the report? A nurse enters a client’s room & finds him sitting in his chair. He states, “I fell in the shower, but I got myself back up & into my chair.” How should the nurse document this in the client’s chart? A nursing instructor is reviewing documentation w/a group of nursing students. Which of the following legal guidelines should they follow when documenting a client’s record? Select all that apply The skin barrier covering a client’s intestinal fistula keeps falling off when she stands up to ambulate. The nurse has reapplied it twice during the shift, but it remains intact only when the client is supine in bed. The nurse telephoned the physical therapist about the difficulties containing the drainage from the fistula, so the therapist didn’t ambulate the client today. The client sat in a chair during lunch w/an absorbent pad over the fistula. The client ate all the food on her tray. The wound care nurse confirmed that she will see the client later today. The client states she feels frustrated at not having physical therapy, but the nurse thinks the client welcomed having a day to rest. Which of the following information should the nurse include in the change-of-shift report? Select all that apply. A nurse is receiving a provider’s prescription by telephone for morphine for a client who is reporting moderate to severe pain. Which of the following nursing actions are appropriate? Select all that apply A nurse is caring for an older adult client who lives alone & is to be discharged in 3 days. He states that it is difficult to prepare adequate nutritious meals at home for just 1 person. To which of the following members of the health care team should the nurse refer him? A goal for a client who has difficulty w/self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral w/which of the following members of the inter-professional care team? A client who is postop following a knee arthroplasty is concerned about the adverse effects of the medication he is receiving for pain management. Which of the following members of the inter-professional care team may assist the client in understanding the medication’s effects? Select all that apply. A client who has had a cerebrovascular accident has persistent problems w/dysphagia. The nurse caring for the client should initiate a referral w/which of the following members of the inter-professional care team? A nursing instructor is acquainting a group of nursing students w/the roles of the various members of the health care team they will encounter on a medical-surgical unit. When she gives examples of the types of tasks CNAs may perform, which of the following client activities should she include? Select all. A nurse in a provider’s office is preparing to assess a young adult male client’s musculoskeletal system as part of a comprehensive physical examination. Which of the following findings should the nurse expect? Select all. A nurse is evaluating a client’s neurosensory system. To evaluate stereo-gnosis, she would ask the client to close his eyes & identify which of the following items? A nurse is assessing a client who reports pain when the nurse evaluates the internal rotation of her right shoulder. Which of the following activities is this problem likely to affect? A nurse is preforming a neurosensory examination for a client. Which of the following tests should the nurse preform to test the client’s balance? Select all. A nurse is collecting data from an older adult client as part of a neurosensory examination. Which of the following findings should the nurse expect as changes associated w/aging? Select all. A nurse is providing discharge instructions to a client who has a prescription for the use of oxygen in his home. Which of the following should the nurse teach the client about using oxygen safely in his home? Select all. A nurse educator is conducting a parenting class for new parents. Which of the following statements made by a participant indicates a need for further clarification & instruction? A home health nurse is discussing the dangers of carbon monoxide poisoning w/a client. Which of the following information should the nurse include in her counseling? A nurse educator is presenting a module on basic first aid for newly licensed home health nurses. The nurse educator evaluates the teaching as effective when the newly licensed nurse states the client who has heat stroke will have which of the following? A home health nurse is discussing the dangers of food poisoning w/a client. Which of the following info should the nurse include in her counseling? Select all. A nurse is caring for a client diagnosed w/severe acute respiratory syndrome (SARS). The nurse is aware that health care professionals are required to report communicable & infectious diseases. Which of the following illustrate the rationale for reporting? Select all. A nurse is contributing to the plan of care for a client who is being admitted to the facility w/a suspected diagnosis of pertussis. Which of the following should the nurse include in the plan of care? Select all. A nurse is caring for a client who presents w/linear clusters of fluid-containing vesicles w/some crustings. Which of the following should the nurse suspect? A nurse is caring for a client who reports severe sore throat, pain when swallowing, & swollen lymph nodes. The client is experiencing which of the following stages of infection? A nurse educator is reviewing w/a newly hired nurse the difference in clinical manifestations of a localized vs. a systemic infection. The nurse indicates understanding when she states that which of the following are clinical manifestations of a systemic infection? Select all. A nurse is teaching a young adult client about health promotion & illness prevention. Which of the following statements by the client indicates an understanding of the teaching? A nursing instructor is explaining the various stages of the lifespan to a group of nursing students. The nurse should offer which of the following behaviors by a young adult as an example of appropriate psychosocial development? A nurse is counseling a young adult who describes having difficulty dealing w/several issues. Which of the following problems the client verbalized should the nurse identify as the priority for further assessment & intervention? A nurse is reviewing safety precautions w/a group of young adults at a community health fair. Which of the following recommendations should the nurse include specifically for this age group? Select all. A nurse is reviewing the CDC’s immunization recommendations w/a young adult client. Which of the following recommendations should the nurse include in this discussion? Select all. A nurse is caring for an 82-yr-old client in the ER who has an oral body temp of 38.3 C (101 F), a pulse rate of 114/min, & a RR of 22/min. He is restless & his skin is warm. Which of the following are appropriate nursing interventions for this client? Select all. A nurse is instructing an AP in caring for a client who has a low platelet count as a result of chemo. Which of the following is the nurse’s priority instruction for measuring vital signs for this client? A nurse is instructing a group of nursing students in measuring a client’s RR. Which of the following guidelines should the nurse include? Select all. A nurse who is admitting a client who has a fractured femur obtains a BP reading of 140/94 mmHg. The client denies any history of HTN. Which of the following actions should the nurse take next? A nurse is performing an admission assessment on a client. When measuring her vital signs, the nurse finds that her radial pulse rate 68/min & her simultaneous apical pulse rate is 84/min. What is the client’s pulse deficit? A nurse is caring for a client who will perform fecal occult blood testing at home. Which of the following info should the nurse include when explaining the procedure to the client? A nurse is talking w/a client who reports constipation. When the nurse discusses dietary changes that can help prevent constipation, which of the following foods should the nurse recommend? A nurse is caring for a client who has had diarrhea for the past 4 days. When assessing the client, the nurse should expect which of the following findings? Select all. A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure. Which of the following are appropriate steps for the nurse to take? Select all. While a nurse is administering a cleansing enema, the client reports abdominal cramping. Which of the following is the appropriate intervention? A nurse is caring for a client who has been sitting in a chair for 3 hrs. Which of the following problems is the client at risk for developing? A nurse is caring for a client who is on bed rest. Which of the following interventions should the nurse implement to maintain the patency of the client’s airway? A nurse is caring for a client who is postop. Which of the following nursing interventions reduce the risk of thrombus development? Select all. : A nurse is instructing a postop client about the sequential compression device the provider has prescribed. Which of the following statements should indicate to the nurse that the client understands the teaching? To promote the safe use of a cane for a client who is recovering from a minor musculoskeletal injury of the left lower extremity, which of the following instructions should the nurse provide? Select all that apply. A nurse is assessing the pain level of a client who has come to the ER reporting severe abd. pain. The nurse asks the client whether he has nausea & has been vomiting. The nurse is assessing which of the following? A nurse is assessing a client who is reporting severe pain despite analgesia. The nurse can best assess the intensity of the client’s pain by: A nurse is obtaining history from a client who has pain. The nurse’s guiding principle throughout this process should be that: A nurse is caring for a client who is receiving morphine via a PCA infusion device after abdominal surgery. Which of the following statements indicates that the client knows how to use the device? A nurse is monitoring a client who is receiving opioid analgesia for adv effects of the med. Which of the following effects should the nurse anticipate? Select all. A nurse is assessing a client who takes haloperidol (Haldol) for the tx of schizophrenia. Which of the following findings should the nurse document as extrapyramidal symptoms (EPS)? Select all. A nurse is providing teaching about managing anticholinergic effects for a client who has a new prescription for oxybutunin (Ditropan XL). Which of the following are appropriate to include in the teaching? Select all. A nurse is reviewing the reported meds of a client who was recently admitted. The meds include cimetidine (Tagamet) & imipramine hydrochloride (Tofranil). Knowing that cimetidine decreases the metabolism of imipramine hydrochloride, the nurse should identify that this combination is likely to result in which of the following effects? A nurse in an outpatient clinic is caring for a client who states she is trying to get pregnant. The client currently takes a Category D pregnancy risk med for the control of seizures. Which of the following statements by the nurse is appropriate? A nurse in an outpatient surgical center is admitting a client for a laparoscopic procedure. The client has a prescription for preoperative diazepam (Valium). Prior to administering the med, which of the following actions is the highest priority? A nurse is preparing to administer methylprednisolone acetate (Depo-Medrol) 10 mg by IV bolus. The amount available is 40 mg/mL. How many mL should the nurse administer? (round to nearest tenth) A nurse is preparing to administer lactated Ringer’s (LR) IV 100 mL over 15min. The nurse should set the infusion pump to deliver how many mL/hr? (round to nearest whole number) A nurse is preparing to administer 0.9% sodium chloride (0.9% NaCl) 250 mL IV to infuse over 30min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (round to nearest whole number) A nurse is caring for a client who is at high risk for aspiration. Which of the following is an appropriate nursing intervention? A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following is the body’s priority energy reserve? A nurse is caring for a client who is on a low-residue diet. The nurse should expect to see which of the following foods on the client’s meal tray? A nurse is caring for a client who weighs 80 kg (176 lb) and is 1.6 m (5 ft 3 in) tall. Calculate her BMI & determine whether this client is obese based on her BMI. . A nurse in a senior center is counseling a group of older adults about their nutritional needs & considerations. Which of the following info should the nurse include? Select all. A nurse is caring for a client who is 1 day postop following a total knee arthroplasty. The client states his pain level is a 10 on a scale of 0-10. After reviewing the client’s medication administration record, which of the following medications should the nurse administer? A nurse is teaching a client about taking multiple oral meds at home to include time-release capsules, liquid meds, enteric-coated pills, & narcotics. Which of the following statements by the client indicates an understanding of the teaching? A nurse is teaching a client how to administer medication through a jejunostomy tube. Which of the following instructions should the nurse include in the teaching? A nurse educator is teaching a module on pharmacokinetics to a group of newly licensed nurses. Which of the following statements by a newly licensed nurse indicates an understanding of the 1st-pass effect? A nurse is teaching an adult client how to administer ear drops. Which of the following statements by the client indicates understanding of the proper technique? A nurse prepares to administer an injection of morphine (Duramorph) to a client who reports pain. Prior to administering, the nurse is called to another room to assist another client onto a bedpan. She asks a 2nd nurse to give the injection. Which of the following actions should the 2nd nurse take? A nurse is preparing to administer a med to a client. The med was scheduled for administration at 0900. Which of the following are acceptable administration times for this med? Select all. A nurse is working w/a newly hired nurse who is administering meds to clients. Which of the following actions by the newly hired nurse indicates an understanding of med error prevention? A nurse educator is teaching a module on safe med administration to newly hired nurses. Which of the following statements by the newly hired nurse indicate understanding of the nurse’s responsibility when implementing med therapy? Select all. A nurse is preparing to administer digoxin (Lanoxin) to a client who states, “I don’t want to take that med. I do not want one more pill.” Which of the following responses by the nurse is appropriate in this situation? A nurse is assessing a client who has an acute resp. infection that puts her at risk for hypoxemia. Which of the following findings are early indications that should alert the nurse that the client is developing hypoxemia? Select all. A nurse is caring for a client who is having difficulty breathing. The client is lying in bed & is already receiving oxygen therapy via nasal cannula. Which of the following interventions is the nurse’s priority? A nurse is preparing to preform endotracheal suctioning for a client. Which of the following are appropriate guidelines for the nurse to follow? Select all. A nurse is caring for a client who has a tracheostomy. Which of the following actions should the nurse take each time he provides tracheostomy care? Select all. A provider is discharging a client with a prescription from home oxygen therapy via nasal cannula. Client & family teaching by the nurse should include which of the following? Select all. A nurse is delivering an enteral feeding to a client who has an NG tube in place for intermittent feedings. When the nurse pours water into the syringe after the formula drains from the syringe, the client asks the nurse why the water is necessary. Which of the following is an appropriate response by the nurse? A nurse is preparing to instill an enteral feeding to a client who has an NG tube in place. Which of the following is the nurse’s highest assessment priority before performing this procedure? A nurse is caring for a client who is receiving continuous enteral feedings. Which of the following nursing interventions is the highest priority when the nurse suspects aspiration of the feeding? A nurse is caring for a client in a long-term care facility who is receiving enteral feedings via NG tube. Which of the following is an appropriate nursing action prior to administering the tube feeding? Select all that apply A nurse is preparing to insert an NG tube for a client who requires gastric decompression. Which of the following actions should the nurse perform prior to beginning the procedure? Select all. An adolescent who has diabetes mellitus is 2 days postop following an appendectomy. The client is tolerating a regular diet. He has ambulated successfully around the unit w/assistance. He requests pain meds Q 6-8 hr while reporting pain at a 2 on a scale of 1-10 after receiving the med. His incision is approximated & free of redness, w/scant serous drainage on the dressing. Which of the following risk factors for poor wound healing does this client have? Select all. A nurse is assessing a client who is 5 days post op following abd. surgery. The surgeon suspects an incisional wound infection & has prescribed antibiotic therapy for the nurse to initiate after collecting wound & blood specimens for culture & sensitivity. Which of the following assessment findings should the nurse expect? Select all. A nursing instructor is reviewing the wound healing process w/a group of nursing students. They should be able to identify which of the following alterations as a wound or injury that heals by secondary intention? Select all. A client who had abd. surgery 24 hr ago reports a pulling sensation & pain in his surgical incision. The nurse checks the client’s surgical wound & finds the wound separated w/viscera protruding. Which of the following interventions is appropriate? Select all. A nurse is caring for an older adult client who is at risk for developing pressure ulcers. Which of the following interventions should the nurse use to help maintain the integrity of the client’s skin? Select all. 

Essay about covid-19 

I just need a summary of the article. 

see attachment 

Assessing and Planning Care for an Elderly Person

In order to gain an insight into the world of elder adults, it is important to understand how they view themselves and the values they hold. Additionally, it is important to assess and determine his/her needs and establish appropriate interventions for this individual.

In a Microsoft Word document of 4-5 pages formatted in APA 7 style, you will discuss your interview of an older adult. You can use a friend, family member, or co-worker. The older adult must be age 65 years or older.

There are two parts to this assignment – the psychosocial interview component and the functional assessment.

Interview

Download the patient questionnaire (see attachment). Use this format to record the person’s responses.

• Include 2–3 questions of your own to get a complete picture of the older adult.

• Summarize your findings.

• Include the questionnaire with responses in the Appendix of your paper.

Assessment

After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of a functional assessment.

• Use the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.

o Tinetti Balance and Gait Evaluation

o Katz Index of Activities of Daily Living

o Assessment of Home Safety

o The Barthel Index

o Do not include a name on each tool, but do include professional or other designation, and age. Your name should also be identified on the tool.

 Include these tools in the Appendix.

• Based on your assessment:

o Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment.

o Identify at least 4–6 preliminary issues.

o Identify three alterations in health that you would propose and describe them.

o Identify a minimum of three comprehensive interventions for each alteration.

o Integrate cultural considerations in your interventions.

On a separate references page, cite all sources using APA 7 format. Please note that the title and reference pages should not be included in the total page count of your paper.

Description

Review the PICO / Levels of Research rubric (see rubric attached)

Identify a nursing EBP or Research resource found by searching the internet. This article should be applicable to informatics (telehealth, EMR, Smart Cards, any other topic). Summarize the research article and findings. Is this a practice issue that is evidence-based and should be analyzed using PICO? Is this a non-clinical or research-based topic that should be evaluated using levels of research? Provide an overview of PICO or Levels of Research (whichever is appropriate for your article) and explain why they are used. Discuss how you used information literacy skills (PICO or levels of research evidence) to evaluate the healthcare information that you found.

This 2-page assignment should be submitted following APA format including title and reference pages.

Review: “You Tube: Safe at School” by the American Diabetes Association. With your knowledge of who needs to be trained, how would you use this series of 13 chapters to support your students with diabetes? Review Chapter 13 and discuss the legal implications of caring for your students with diabetes. 

Two different  papers same topic

 You should respond in a well-developed paragraph (300–350 words) integrating an evidence-based resource , Respectfully agree and disagree with your peers’ responses and explain your reasoning by including your rationales in your explanation .At Least 2 APA references each

Response 1 

The purpose of this discussion is to discuss and describe treatment for R.S. who is diagnosed with bacterial vaginosis. Identifying the specific goals of treatment for this patient is essential to care for R.S. The specific goal of the Metronidazole treatment is to resolve the signs and symptoms of infection (Vallerand & Sanoski. 2016). The length of time for complete resolution of the infection depends on the organism and site of infection Vallerand, A. & Sanoski, C. (2016). Moreover, other specific goal of  treatment is to relieve vaginal symptoms, and potentially decrease the risk of acquiring HIV and other sexually transmitted infections such as Chlamydia, trachomatis, Neisseria gonorrhea, and viral STIs (Coudray & Madhivanan. 2020).  The drug therapy this writer would prescribe is metronidazole because it will help to fight the signs and symptoms of infection in R.S. (Woo, Terri Moser, Robinson & Marylou. 2020). Metronidazole is the first pharmacological method to treat bacterial vaginosis (Woo, Terri Moser, Robinson & Marylou. 2020). This medication is indicated for anaerobic bacterial infection (Woo, Terri Moser, Robinson & Marylou. 2020). The metronidazole mechanism of action is disrupting DNA and protein synthesis in susceptible organisms (Vallerand & Sanoski. 2016).  This writer would prescribe Metronidazole as 500 mg orally twice daily for 7 days (Woo, Terri Moser, Robinson & Marylou. 2020).

Metronidazole has parameters for monitoring the success of the therapy. This writer will assess the patient R.S. for signs of infection by monitoring the vitals signs, the appearance of discharge, and the white blood cell count (Vallerand & Sanoski. 2016). This assessment will  occur at the beginning of and throughout therapy (Vallerand & Sanoski. 2016).  Additionally, this writer will obtain specimens for culture and sensitivity before therapy and at the end of the therapy (Vallerand & Sanoski. 2016). Patient education is a crucial component of the prescribed treatment. This writer will instruct the patient to take medication as direction and even when feeling better (Vallerand & Sanoski. 2016). This writer will also instruct the patient that metronidazole may be taken with meals or a snack to decrease GI irritation (Woo, Terri Moser, Robinson & Marylou. 2020). More importantly, this writer will instruct and educate patient to avoid alcohol beverages during therapy and for 48 hours after completing it (Woo, Terri Moser, Robinson & Marylou. 2020). Similarly, this writer will instruct patient to abstain from sexual contact or use condoms for seven days after therapy begins (Woo, Terri Moser, Robinson & Marylou. 2020). Lastly, this will advise the patient to consult health care professional if no improvement in a few days or if signs and symptoms of superinfection (black, furry overgrowth on tongue; vaginal itching or discharge; loose or foul-smelling stools) develop (Vallerand & Sanoski. 2016). Metronidazole has several adverse effects. If the patient has seizures or stevens-johnson syndrome while taking this medication this writer would change the medication (Vallerand & Sanoski. 2016). One drug-drug interaction occurs with alcohol (Vallerand & Sanoski. 2016). Disulfram-like reaction may occur with alcohol ingestion (Vallerand & Sanoski. 2016).

Bacterial vaginosis has two treatment options. If the patient does not show signs of improvement with metronidazole. The second choice therapy is clindamycin: oral preparations or intravaginal ovules. Clindamycin would be prescribed to the patient as 300 mg orally twice daily for 7 days (Petrina, Cosentino, Rabe & Hillier. 2017). Clindamycin is the second line of treatment because the medication is an anti-infective used to treat symptomatic women (Vallerand & Sanoski. 2016). Alternative methods to help treat bacterial vaginosis are yogurt, probiotics, or boric acid (Falconi‐McCahill. 2019). Lifestyle management should be recommended for R.S. This writer will educate patients that many of the infections treated with metronidazole are due to sexual transmission (Woo, Terri Moser, Robinson & Marylou. 2020). This writer will advise R.S. the route of transmission and promote refraining from activity until the treatment is complete (Woo, Terri Moser, Robinson & Marylou. 2020). 

Response 2

  Some conditions may affect the client in the community which can make the client feel embarrassed to seek medical attention, but it can be as dangerous as any other health condition when treatment is not delivered promptly and those conditions are associated with sexually transmitted diseases (STD). It can be situations when the person may also infect the partner and both may need treatment. In the discussion board this week R.S. is a 32 years old female which has been having a vaginal discharge for the past month and only have one partner and has been diagnosed with Bacterial Vaginosis. Although Bacterial vaginosis is not considered a sexually transmitted infection the reason for occurrence is associated with multiple sex partners, douching, unprotected intercourse, and the decrease amount of natural flora (Woo, 2020). This condition is caused primarily due to a replacement of the normal flora which is acidic at pH 4.5 to an overgrowth of anaerobic organisms such as Prevotella spp., Mobiluncus spp., Gardnerella vaginalis, or Mycoplasma hominis (Woo, 2020). These organisms tend to grow in a less acidic environment, as presented by the case study were R.S. pH is 5.5 during microscopic examination.

        The main goal of treatment for this condition is to make the symptoms subside before it morphs into something more serious. The first-line treatment is usually initiated with metronidazole 0.75% gel applied vaginally for five days (Allen, 2020). By initiating this therapy, the patient will also monitor itself and follow up with the prescriber whether the treatment is being effective. This type of condition may reoccur on multiple occasions and is important for the patient to seek the prescriber if the condition reoccurs where a different treatment option may be needed. The reason for choosing this treatment option is that it is the least amount of time and can have a better effect since is applied to the site. However, the patient needs to take some precautions during therapy such as do not consume alcohol during and at least three days after the completion of treatment due to the risk for disulfiram-like reactions (Woo, 2020). The patient should also report any burning, stinging, or change in taste which are rare symptoms, but it should be reported while in this therapy (Mayo clinic, 2020). The prescriber should seek a different treatment or add therapy if this first-line treatment is not being effective.

        Although there is a different option that someone may take this writer would prescribe clindamycin 300mg twice daily for 7 days as second-line therapy. The reason for prescribing an oral medication is that it would act quickly and have a more systemic action instead of continuing with the topical option. Besides, it could only be that the patient did not have a useful treatment with the clotrimazole cream due to not following the treatment correctly which can affect the overall treatment. By reading the literature this writer did not found many over-the-counter (OTC) treatment options while treating this condition. The most mentioned OTC was the introduction of probiotics as an adjunct therapy with the antibiotic, but there was no convincing data that attest to its efficacy (Ellington, & Saccomano, 2020). However, while taking antibiotics such as clindamycin, taking a probiotic can decrease the chances of damaging the intestinal natural flora, in this situation it may not help with the current bacterial vaginosis, but it will protect the natural flora which implies that it may be a good reason to take a probiotic while on antibiotic therapy. The main dietary recommendation while taking clindamycin is not to take grapefruit juice together. Clindamycin is a CYP3A4 substrate and grapefruit juice is a strong inhibitor of this substrate, which implies that while taking Clindamycin R.S. should avoid grapefruit juice (WellRx, 2020).Other education factors can help this patient prevent reoccurrences such as limiting sexual partners, using condoms, improving hygiene with sharing sex toys, and the avoidance of douching (Ellington, K., & Saccomano, S. J. (2020). Overall, educating the patient to take/administer the medication as prescribed. Communicate with the prescriber any adverse effects are also an important recommendation to be made while treating the patient in the community.

RUBRIC:

 Discussion Question Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsQuality of Initial PostProvides clear examples supported by course content and references.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

All instruction requirements noted.

40 pointsComponents are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints.

Meets all requirements within the discussion instructions.

Cites two references.

35 pointsComponents are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development.

Is missing one component/requirement of the discussion instructions.

Cites one reference, or references do not clearly support content.

Most instruction requirements are noted.

31 pointsAbsent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No references cited.

Missing several instruction requirements.

Submits post late.

27 points40Peer Response PostOffers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

2 points5Total Points100