Monthly Archives: May 2023

1- It is important to emphasize comprehensive and broadly defined health promotion. Discuss key components of pediatric health promotion.

2-3 paragraphs of 3 sentences each

3- APA style

4- 2 references not older than 2015

A patient with cancer, receiving chemotherapy is admitted with a systemic mycoses. She is going to be started on amphotericin B to treat the infection. 

What additional information needs to be gathered about this patient?

Why is this patient at risk for a fungal infection?

The nurse will anticipate the adverse effects of this medication on specific organs. What baseline lab tests should the nurse expect to review and regularly monitor in this patient and why?

What are the major adverse effects of amphotericin B

What steps will the nurse take to decrease the effects on the patient.

Describe comfort measures that should be used for this patient.

Patients receiving chemotherapy are at risk of myelosuppression. What does this mean and how will the nurse care for the patient because of the myelosuppression?

 Chapter 9 questions at the end of chapter 9

Page 1: 

Discussion Question 1—Please write 4 paragraphs with each paragraph containing 50-60 words.

Page 2: 

Discussion Question 2—Please write 4 paragraphs with each paragraph containing 50-60 words.

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Discussion Question 4—Please write 4 paragraphs with each paragraph containing 50-60 words.

Page 4: 

Discussion Question 5—Please write 4 paragraphs with each paragraph containing 50-60 words.

Page 5: 

Discussion Question 6—Please write 4 paragraphs with each paragraph containing 50-60 words.

Book Link: https://drive.google.com/file/d/1Lho7gBgscbBQ1CFC16v6zMPSPHm2iDDV/view

Imagine that, for about a year, your nursing unit has been involved in an intensive campaign to improve patient satisfaction scores with pain management. You are getting good data from your patients, as the length of stay on this inpatient geriatric medical nursing unit is only about 6 days. Your hospital does 100% survey to inpatients, and the response rate is about 25%, which is higher than it has been. This notwithstanding, the percent of “patient very satisfied” (top box), with a score of 5, has been in the low 70s. The national benchmark for medical surgical units like yours is about 85% very satisfied. Of all the units in your hospital, your unit is the lowest scoring on this HCAPHS survey. But as your unit is the only geriatric medical nursing unit in the hospital, you’d always thought it was the nature of the patient population.
You have been the day shift representative to the QI team, and the scores on your unit are posted monthly. Here are the numerous strategies that have been tried on your unit and the timeframes.

Document: Strategies and Interventions (PDF)–attached below

For this Discussion, examine the strategies and interventions tried in your unit and consider the following questions: a) Were the strategies effective in creating a sustainable change on your nursing unit, and b) To what extent can your nurse manager and CNO count on your unit exceeding the national benchmark in the next quarter, the next year? That is, does this run chart have some predictive ability? Does the run chart support the nursing unit’s decision to celebrate? To what extent can the leadership be confident that the trend will continue?

By Day 3

Based on the scenario, explain what was done successfully and where improvement was needed in the quality improvement process. Identify the performance improvement tools, and explain how they contributed to the outcome.

Support your response with references from the Resources and professional nursing literature. Your posts need to be written at the capstone level (see checklist).

This wks resources attached and follow:

https://support.microsoft.com/en-gb/office/use-charts-and-graphs-in-your-presentation-c74616f1-a5b2-4a37-8695-fbcc043bf526?ui=en-us&rs=en-gb&ad=gb

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). (Refer to AWE Checklist, Capstone)

 Describe three roles of the human resources department in a major hospital without including hiring or firing of personnel. Discuss why quality improvement and standard operating procedures are enforced in the human resources group. Provide supporting references for your response. PLEASE INCLUDE IN-TEXT CITATION AND REFERENCE

• Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.
  Note: For guidance on nursing and counseling theories, refer to this week’s Learning Resources.
• Explain why you selected these theories. Support your approach with evidence-based literature.
• Develop at least three goals and at least three objectives for the practicum experience in this course.
• Create a timeline of practicum activities based on your practicum requirements.

 I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

Main Discussion Post

Explain why a developmental assessment of children and adolescents is important

According to the CDC (2020), a mentally healthy child who reaches his or her developmental and emotional milestones develops healthy social and coping skills when confronted with adverse situations. Mental health disorders among children as described as significant alterations in the way children learn, behave, or handle difficult and stressful emotions (CDC website, 2020). According to Saddock et al. (2014), the expression of psychopathology in children can be related to age and stage of development. To perform a thorough assessment of a child, the practitioner must have sufficient knowledge of the development stages of children of all ages (Saddock et al., 2014). Understanding children’s developmental stages and what is “normal” for any age is crucial in identifying psychopathology versus expected behavior and responses in this patient population (Saddock et al., 2014).

Describe two assessment instruments and explain why they are used for children and adolescents but not adults

CAPA: Child and Adolescent Psychiatric Assessment- The CAPA instrument is interview-based and used in children between the ages of 9 and 17 (Saddock et al., 2014). The CAPA covers disruptive disorders, mood disorders, somatization symptoms, tic disorders, PTSD, schizophrenia, substance use disorders, sleep disorders, anxiety disorders, elimination disorders, adaptive behavior disorders, and eating disorders (Saddock et al., 2014). The CAPA is available in a segmented form allowing for individual diagnostic units to be administered without conducting a full interview (Saddock et al., 2014). The CAPA takes about one hour to administer and focuses on symptoms occurring three months before the interview (Saddock et al., 2014). The CAPA provides ratings for both severity and presence of symptoms and can be used to formulate diagnoses in conjunction with the DSM-5 (Saddock et al., 2014). Training is required to administer the CAPA, and clinical judgment is required to interpret symptoms.

Dominic-R: The Dominic-R is a cartoon-like instrument designed to assess self-reported mental health in children ages 6-11 years of age (Bajeax et al., 2018). This instrument uses a picture of a child named Dominic, who is enduring the symptoms in question (Saddock et al., 2014). In the Dominic-R computerized version, “Dominic” is also available in Black, White, Asian, and Latino (Saddock et al., 2014). This tool demonstrates the “abstract emotional and behavioral content of diagnostic entities per the DSM-III, but information gathered with the use of this instrument can be applied to DSM-5 diagnostic criteria” (Saddock et al., p. 1111, 2014). With each picture, a sentence is read to the child about the emotion or situation the cartoon child is experiencing. The child is asked if they have experienced the same feeling (Saddock et al., 2014). Diagnoses covered by the Dominic-R include separation anxiety, depression, dysthymia, ADHD, ODD, conduct disorder, and specific phobias (Saddock et al., 2014). This assessment’s paper form takes approximately 20 minutes to administer, and the computer form takes about 15 minutes (Saddock et al., 2014).

Describe two treatment options for children and adolescents that may not be used when treating adults

Parent support– According to the National Institute of Mental Health (2020), parental support includes individual or group therapy that includes training. The opportunity to talk with other parents can provide new strategies for supporting a child and managing problematic behavior positively. The counselor can also guide parents on communicating with the child’s school (NIMH website, 2020).

Age-specific use of instruments– For example, the Dominic-R is explicitly used for children between the ages of six through 11. Instruments used with young children are designed to match their cognitive-developmental level and retain their attention (Bajeux et al., 2018). Several studies have demonstrated that the Dominic-R is quite sensitive in detecting differences in behavior that otherwise might not be detected by parent or teacher-reported questionnaires (Bajeux et al., 2018).

Explain the role parents play in assessment and treatment

According to Saddock et al. (2014), an interview with the parents and caretakers is crucial to obtain a chronological history of the child’s growth and development. A detailed developmental history and specifics of any stressors or significant events that may have influenced the child’s development must be identified (Saddock et al., 2014). The psychiatric history of the parents, family dynamics, marital status, and the parents’ emotional adjustments are also identified during the child’s treatment (Saddock et al., 2014). The child’s parents will often be the best informants of the child’s early developmental history, along with previous medical or psychiatric history (Saddock et al., 2014).

References

CDC website: What is children’s mental health (2020). Retrieved from https://www.cdc.gov/

childrensmentalhealth/basics.html

Bajeux, E., Klemanski, D., Husky, M., Leray, E., Chee, C., Shojaei, T., Fermanian, C., & Kovess-Masfety, V.

              (2018). Factors associated with parent-child discrepancies in reports of mental health disorders

              in young children. Child Psychiatry and Human Development. (49)1003-1010. Retrieved from

https://doi.org/10.1007/s10578-018-0815-7

National Institute of Mental Health website. (2020). Children and mental health. Retrieved from http://

www.nimh.nih.gov/health/publications/children-and-mental-health/index.shtml

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral

              Sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  In a well-developed paragraph (300–350 words) to each peer integrating atleast 2 an evidence-based resource, APA format. Respectfully agree and disagree with the responses and explain your reasoning by including your rationales in your explanation.

Response 1

 The purpose of this post is to discuss diagnosis of RR case study. After reviewing the present complaint and past medical history of RR, this writer suspects that the patient has pneumonia. This writer suspects that either of the following S. pneumoniae, H. influenzae, S. aureus, or gram-negative bacteria was the cause of the infection (Woo, Terri Moser, Robinson & Marylou. 2020). This is because RR has symptoms of fever, chills, green sputum (Woo, Terri Moser, Robinson & Marylou. 2020). Additionally, RR has complaints of pain in the right mid-back with deep breathing and coughing (Woo, Terri Moser, Robinson & Marylou. 2020). Additionally, RR had rales during the auscultation of the lungs in the right lower-posterior lung field (Woo, Terri Moser, Robinson & Marylou. 2020). As a result, ordering a lung ultrasound is beneficial to solidify the diagnosis of pneumonia (Long et al., 2017).

Pneumonia is an infection of one or both lungs (Zambare & Thalkari. 2019). The cause of pneumonia is from either bacteria, viruses, or fungi (Zambare & Thalkari. 2019). As a healthcare provider assessing for the cause of pneumonia in patient RR is crucial because pneumonia can be life-threatening (Zambare & Thalkari. 2019). The goal of treatment is to return to the respiratory status before having pneumonia (Woo, Terri Moser, Robinson & Marylou. 2020). This writer would assess the last use of antibiotics to ensure no antibiotics in the past 3 months, and the patient was previously healthly with no cardiopulmonary disease (Woo, Terri Moser, Robinson & Marylou. 2020).The first choice antibiotic this writer would recommend to treat RR with is an advanced-generation macrolide, such as azithromycin or clarithromycin (Woo, Terri Moser, Robinson & Marylou. 2020). Erythromycin would mostly likely be used to treat RR pneumonia because it is the least expensive of the macrolides (Woo, Terri Moser, Robinson & Marylou. 2020). If RR is allergic to macrolide, then this writer would use doxycycline for treatment (Woo, Terri Moser, Robinson & Marylou. 2020). The patient should respond to treatment within 48 to 72 hours, unless the patient illness is not improving (Woo, Terri Moser, Robinson & Marylou. 2020). Due to RR not having any comorbidities fluoroquinolone ushc as moxifloxacin, gemifloxacin, or levofloxacin is not needed for treating pneumonia (Woo, Terri Moser, Robinson & Marylou. 2020).

Erythromycin is the medication used to treatment RR pneumonia. The mechanism of action for macrolide such as erythromycin is to suppresses protein synthesis at the level of the 50S bacterial ribosome (Vallerand & Sanoski. 2016). The therapeutic effect of erythromycin is bacteriostatic action against susceptible bacteria  (Vallerand & Sanoski. 2016). Educating and counseling the patient about the medication is essential for the patient to understand the treatment, expected adverse effects, drug interactions, and length of treatment (Woo, Terri Moser, Robinson & Marylou. 2020). Some of the adverse effects of erythromycin are nausea, vomiting, abdominal pain, and cramping  (Vallerand & Sanoski. 2016). Moreover, RR should be informed to take the medication as prescribed and until finished even if feeling better  (Vallerand & Sanoski. 2016). Patient will be educated that the response to treatment will assist in determining the pathogen (Woo, Terri Moser, Robinson & Marylou. 2020). This writer will discuss lifestyle modifications such as hydration, smoking cessation and rest (Woo, Terri Moser, Robinson & Marylou. 2020). A discussion of worsening symptoms of pneumonia with RR will occur (Woo, Terri Moser, Robinson & Marylou. 2020). Lastly, this writer will inform RR to contact this writer or seek urgent medical care for worsening symptoms (Woo, Terri Moser, Robinson & Marylou. 2020).

Response 2

 The purpose of this discussion is to assess and treat patient RR from the case study provided. RR could have several causes of these symptoms. The test I would focus on due to her health history and symptoms would be for pneumonia, however I would like to rule out Tuberculosis (TB)as well. Mycobacteria is responsible for TB and is defined as an atypical bacterium and are more difficult to treat than other forms of bacteria (Woo & Robinson, 2020). The most common bacteria that causes bacterial pneumonia in America is called Streptococcus pneumoniae (CDC, 2020). Bacterial pneumonia presents with all the symptoms RR lists: fever, productive green sputum, cough that causes pain, difficulty breathing, and rales. Smoking will exacerbate these symptoms. The rule out on TB would be because of her living conditions, patients who are in homeless shelters are at higher risks for being susceptible to TB (Brown, 2019).
The antibiotic used for bacterial community acquired pneumonia is most commonly a combination of azithromycin and ceftriaxone (Woo & Robinson, 2020). Because this condition has not yet been treated starting with the most generally used antibiotics would be recommended. If these medications do not work and the bacteria appears to be resistant other antibiotics can be initiated.
Azithromycin is known as a bacteriostatic or bactericidal antibiotic when given in higher doses (Woo & Robinson, 2020). This is a broad spectrum antibiotic that gram-negative and gram-negative bacteria are susceptible to. Ceftriaxone is a third generation cephalosporin medication that is recommended for broader indications and is more effective against gram-negative bacteria (Woo & Robinson, 2020).
The mechanism of action for azithromycin is that it binds to 50S ribosomal subunit of the causative bacteria and intercepts the detachment of peptidyl tRNA from the ribosomes. The bacteria are dependent on the RNA for protein synthesis therefore, without it the bacteria cannot synthesize (Medscape, 2020). Ceftriaxone works less successfully against gram-positive microorganisms, however, is a better choice for a cephalosporin for resistant organisms. This antibiotic inhibits the production of peptidoglycan which is the bacteria’s enzyme that builds its cell wall. This creates the bacteria lyse (Medscape, 2020).
Studies have concluded that the use of these two medications in a combination therapy has resulted in quicker recovery, less residual symptoms, and a decrease in sepsis occurrence and should be given to high risk patients (Caballero et al., 2011). Given RR’s health history and current living conditions I would conclude that she falls into the high risk population for pneumonia complications. I would also recommend that RR gets plenty of rest and fluid, educate on the benefits of smoking cessation (and offer a nicotine gum prescription), to take the full course of medication even if symptoms resolve, and to come back if any symptoms persist or worsen.

RUBRIC

 Peer Response Post. Offers 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.

Write a paragraph summary about the history and epidemiology of the HIV/AIDS epidemic. include the origin, spread, introduction into the United States and its current state in our society.

* At least 1 citation needed

* Use APA format for all citations

* Minimum of 250 words, not including citation

NOTE * I need two different papers on the same topic*

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