2 coments each one 150 words (CITATION AND REFERENCE)

reply1

Nursing research is at the heart of nursing practice because it helps nurses to stay up to date with evidence-based knowledge that can improve organizational, nursing, and patient outcomes. To ease the search of scholarly materials and ensure that GCU students produce sound research that can add value to nursing literature and practice, the GCU Library provides a large number of scholarly databases that a student can actually peruse in search of journals, articles, and periodicals to support their projects.

Two GCU Library scholarly databases that will help me find the best research articles to support my capstone project change proposal will include Ovid Nursing Essential database which has access to over 125 full-text nursing journals that covers a wide range of nursing topic, including titles from highly respected Lippincott Williams & Wilkins (Grand Canyon University, n. d.-a). Another GCU Library database that I can resort to in finding evidence to support my capstone project change proposal is the EBSCO database which include the CINAHL Complete, Health Source: Nursing/Academic Edition, PsycARTICLES, PsycINFO, ERIC(EBSCO) etc (GCU, n. d.-b).

The strengths of these two databases over Google Scholar or general Internet search cannot be underestimated. First, they can help to narrow my search to specific journals and articles that are peer-reviewed, unlike the Google Scholar or general Internet search that can provide a whole range of journals and articles that are not peer reviewed. In addition, searching for research evidence via these two GCU databases can help to save a lot of time in research. In a nutshell, GCU scholarly databases provide more valuable research tools for conducting both quantitative and qualitative research than the Google Scholar.

                                                                                References

Grand Canyon University. (n. d.-a). Ovid Nursing Essential Current Status. https://libanswers.gcu.edu/systems/6123

Grand Canyon University. (n. d.-a). EBSCO Databases Current Status. https://libanswers.gcu.edu/systems/5941

reply2

The Grand Canon university library has 92 databases with full access to more than 6000 text journals and articles, each database has exclusive feature, which help students to specialize and focus on result in more than one subject (Grand Canyon University, 2017). I propose and recommend CINAHL and ProQuest nursing and allied health source databases the best sources for my research proposal. CINAHL database has access to variety of articles from health professionals and other researchers with good understanding of nursing encounter. The database allows researchers to find appropriate medical terms used in literature thus I will be able to collect more information useful to my EBP proposal.

ProQuest nursing and allied health source database is the other database I will use in my EBP proposal. Similar to CINAHL, ProQuest provides an extensive variety in nursing, allied health related fields, videos on clinical practical, evidence based resources such as dissertation and logic review plus reference materials (Grand Canyon University, 2016). Most librarians prefer and recommend ProQuest database for those students those taking nursing research nursing research and health care related field. Due to the suitability and credibility of the above database, I find it very suitable for my proposal writing. However, though both GCU and google scholar are commonly used internet sources. GCU is more suitable because it is easy to use and offer comprehensive contact to many literature and reference materials as well as google scholar.

References

Grand Canyon University. (2017).

http://library.gcu.edu/Database/Subject?subject=Nursing_And_Health_Sciences

Grand Canyon University. (2016). About the GCU Library. | www.gcu.edu. Retrieved 13

November 2017, from https://www.gcu.edu/future-students/campus- experience/library.php

Advanced health assessment

• Group 2: Severely underweight 12-year-old Hispanic girl with underweight parents who has been bullied in school just recently
 
For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.
To Prepare
• Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
• Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
• Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
• If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
o Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
o Consider how you could encourage parents or caregivers to be proactive toward the child’s health.
• Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
• Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
• If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
o Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
o Consider how you could encourage parents or caregivers to be proactive toward the child’s health.
•
•
Assignment (3–4 pages, not including title and reference pages):
Assignment Option 2: Child Health Case:
Include the following:
• An explanation of the health issues and risks that are relevant to the child you were assigned.
• Describe additional information you would need in order to further assess his or her weight-related health.
• Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
• Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
• Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

journal 3

  

Think about the evidence, concepts, and/or theories (evidence) learned throughout this program and your nurse executive specialization.

Analyze a problem, issue, or situation that you have observed during your practicum experience.

Using a minimum of three peer-reviewed sources of evidence, consider what you have observed within the context of your specialty using appropriate concepts, principles, and theories. Give special attention to observed events that vary from the scholarly literature.

Including personal communications from leaders in health care administration is acceptable; however, this does not replace the requirement for three peer-reviewed sources of evidence.

Determine the degree to which the problem, situation, or issue was addressed in a manner consistent with the theory, concepts, and principles detailed in the evidence.

Given the various evidence-based approaches that can be used in addressing the observed problem, situation, or issue, think about a plan for approaching the matter differently.

Personal Philosophy of Nursing

 Discuss the tenets of nursing’s metaparadigm. Identify personal philosophy of nursing. 

Your paper should include the following:

– Discuss personal philosophy of nursing.
– Articulate changes in personal philosophy over time.
– Discuss factors that impacted change in personal philosophy of nursing.

Submission Instructions:

  • The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
  • The paper should be formatted per current APA and 3-5 pages in length, excluding the title, abstract and references page. Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

100 word positive post with three refences due today at 10 pm

 

Main Post

Pharmacokinetics and Pharmacodynamics

As advanced practice nurses it is important that we understand pharmacokinetics and pharmacodynamics when caring for our patients. There are many factors to consider when prescribing medications because not one person is the same. Pharmacokinetics is the study of drug movement throughout the body, and has four basic processes: absorption, distribution, metabolism, and excretion (Rosenthal, 2021, p 13). Pharmacodynamics is the study of the biochemical and physiologic effects of drugs on the body and the molecular mechanisms by which those effects are produced (Rosenthal, 2021, p 22). In my experience I can not pinpoint one specific scenario in which pharmacokinetic and pharmacodynamic factors altered an anticipated response to a drug but multiple scenarios.

I can think of things to consider when prescribing medications like their medical history, medications they take, whether prescribed or over the counter, compliance, genetics, age, race, and family history. Other things to consider is the patients liver function and renal function, which affect the drugs absorption and excretion rate. One class of drugs that comes to mind are chemotherapy medications. Not everyone has the same outcome with chemotherapeutic agents when treating cancers. Another class of medications are psychotropic medications, some psych medications work better for others and do not work at all for some. And one of the most common ailments hypertension, antihypertensive drugs that work for some and not others. Immunosuppressed, CHF, renal failure, liver failure patients and patients with multiple ailments on multiple medications, all have to be prescribed medications carefully because of possible polypharmacy and drug interactions. A-fib patients prescribed coumadin needing their PT/INR checked to make sure their coumadin is therapeutic, educating them not to eat green leafy vegetables or drink grapefruit juice.

A patient’s genetics may play a role in whether the medication prescribed is going to work or not. It became evident in the 60’s that therapeutic doses of psychotropic medications vary markedly from person to person, with some patients failing to respond despite treatment with high dosages (Lerer, 2004, p158). Among many factors that may influence the drug response, hepatic function, and drug metabolism ae of great importance for nearly all medications used in psychiatry and even more importantly patient compliance with medication use (Lerer, 2004, p158). The CYP2D6 genetic polymorphism was discovered in late 1970’s and represents one of the most intensively studied monogenic variations in drug metabolism, approx. 7% of Caucasians are poor metabolizers of CYP2D6 substrates while the rest are considered as extensive metabolizers (Lerer, 2004, p160). CYP2D6 enzyme has particular significance for clinical psychiatry as it is involved in clearance of many psychotropic drugs such as tricyclic, antidepressants, selective serotonin reuptake inhibitors, classical antipsychotics, some atypical antipsychotics, drugs of abuse and codeine (Lerer, 2004, p160). In patients who rapid metabolize and have multiple copies of CYP2D6, conventional dose titration may cause delays in therapeutic response and lead to prolonged inpatient hospitalization. It is important to know our patient’s, do lab work according to the drugs being prescribed and refer our patients to specialty physicians if necessary.

                Another consideration is gender when prescribing medications. Research shows that women have different absorption due to lower gastric pH and longer gastrointestinal transit, lower P-glycoprotein expression, different body fat percentage than men, and that estrogen in women can affect drug metabolizing enzymes (Pierzchlinska, 2018, p 117). All of the topics discussed are why it is so important to develop an individualized care plan for each patient to provide the best care possible. The care plan should include goals of therapy, interventions, and follow up evaluation of treatment outcomes. Well rounded individualized treatment plans specific for each patient allow patients to establish trusting relationships with their providers.

Reference

Lerer, B. (2004). Pharmacogenetics of psychotropic drugs. (electronic source). Cambridge University Press.

Pierzchlinska, A., & Bialecka, M. (2018). An introduction to gender differences in neurological treatment. Aktualnosci Neurologiczne, 18(3), 117-122. https://doi-org.ezp.waldenulibrary.org/10.15557/AN.2018.0016

Rosenthal, L.D., & Burchum, J.R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier

Discussion post

link to the video: https://youtu.be/aUJD3sGppUo

 

View the persuasive speech, Graham Hill: Why I Am A Weekday Vegetarian. Based on the video, respond to the following questions in your post:

  • What is the speaker’s topic?
  • Who is the speaker’s target audience? How do you know?
  • What is the speaker’s thesis?
  • How did the speaker use logos?
  • How did the speaker use ethos?
  • How did the speaker use pathos?
  • What other persuasive techniques did the speaker use?
  • Did the speaker use visual aids? If so, how did these help persuade you?
  • What defective persuasion did the speaker use?
  • Did the speaker persuade you to listen to their point? Why or why not?

hyperthyriodism

inculde biochemistry, background introduction, cause, sympotms, diagnosis treatment, prevention, and control incl;ude figures charts, pictures etc