Monthly Archives: May 2023

  Respond to the Case Study presented in Chapter 12 (p. 286) about direct-to-consumer advertising of prescription drugs. What impact have you observed in the populations you serve in your nursing practice? Comment on the ethics of this practice, in terms of autonomy, beneficence, non-maleficence, and justice.

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources 

Visit the CINAHL Complete under the A-to-Z Databases on the University Library’s locate and read the article(s) below:

· Arritt, T. (2014). Caring for patients of different religions. Nursing Made Incredibly Easy, 12(6), 38-45.

· Hudson, C.C., Adams, S., Lauderdale, J. (2016). Cultural expressions of intergenerational trauma and mental health nursing implications for U.S. health care delivery following refugee resettlement: An integrative review of the literature. Journal of Transcultural Nursing, 27(3), 286-301. doi: 10.1177/1043659615587591.

L.L. is a 67-year-old male who has been diagnosed with BPH. He is having difficulty with urination. He is currently on Cozaar 100 mg for HTN and his BP is well controlled. He is taking no other medications. The doctor has recommended medication for his BPH, but he would like to try a herbal supplement before taking a prescription medication.

1. Would you recommend a herbal supplement in L.L’s case?

2. If so, what herbal supplement would he take?

3. What is the recommended dosage?

4. What are possible side effects of the herbal supplement?

5. What warnings should you give L.L. before he starts the herbal supplement.

Neurological System

The nervous system is a collection of nerves and specialized cells forming a spectacular network of connections which transmit signals between different parts of the body. It controls the activities of all body organs and tissues. Structurally, it is organized into two parts: the central nervous system, comprising the brain and spinal cord, and the peripheral nervous system, which connects the central nervous system to other parts of the body. 

The aging process is associated with many biological, physiological, environmental, psychological, behavioral, and physical processes. These changes often result in several complex health conditions dubbed geriatric syndromes. Most cells have a short life span and are easily regenerated and replaced by new cells in the human body. On the other hand, nerve cells are generated in vivo, have a longer life span, and are usually not replaced when they die or are destroyed. 

Several changes occur in the central nervous system. Firstly, nerve cells and supporting neuroglia are gradually lost with age. On the other hand, the remaining cells function less efficiently, and there is an increased concentration of harmful materials such as free radicals and iron in the remaining brain tissue (Knight & Nigam, 2017). Secondly, there is a decrease in brain mass leading to decreased function of affected areas such as the cerebral cortex, hippocampus, and motor cortex, manifesting as impairments in higher functions, memory loss, and gait. Thirdly, the ventricles increase in size and due to the loss of cells lining the ventricles. Fourthly, there is a decrease in cerebral blood flow and diminished integrity of the blood-brain barrier over time. There is also a decline in the production of neurotransmitters. Lastly, age-related changes to the vertebrae and intervertebral discs may increase pressure on the spinal cord and its branching nerve roots. This can slow down nerve impulses’ conduction along motor neurons, contributing to reduced muscular strength (Manini et al., 2013).

There is a slowed nerve conduction in the peripheral nervous system attributed to decreased axonal length, loss of mitochondria, and degeneration of peripheral neurons’ myelin sheath. This may result in decreased sensation, slower reflexes, and clumsiness. On top of that, damaged neurons are not repaired efficiently in older adults, and some are not repaired at all. 

The decrease in brain function with aging may impair mental function seen in neurodegenerative conditions such as delirium and dementia. Delirium is defined as an acute confusional state characterized by an acute decline in attention-focus, perception, cognition, and consciousness. In contrast, dementia is an acquired global impairment of intellect, memory, and personality but without impaired consciousness. 

The two conditions are similar in that they exhibit similarities in their presentation: impaired memory and judgment, confusion, disorientation, and variable degrees of paranoia and hallucinations (Fong et al., 2015). However, they also have some differences. Delirium usually has an acute onset, fluctuating course lasting days to weeks can occur at any age but is more common in the elderly with underlying conditions. On the contrary, dementia has an insidious onset, has a chronic course lasting months to years, and is more common in the elderly. Delirium is essentially due to reversible impairment of cerebral oxidative metabolism, while dementia is caused by exogenous insult or an intrinsic process affecting cerebral neurochemistry. The causes of delirium include metabolic disorders, toxins, infections, anatomic disorders, withdrawal, trauma, hypoxia, deficiencies, endocrinopathies, heavy metals, and acute vascular events (Inouye et al., 2014). On the other hand, dementia results from neurodegeneration, vascular defects, toxins, infections, autoimmune disorders, neurometabolic disorders, and other endocrinopathies.

References

Knight, J., & Nigam, Y. (2017). Anatomy and physiology of ageing 5: the nervous system. Nursing times, 113(6), 55-58.

Inouye, S. K., Westendorp, R. G., & Saczynski, J. S. (2014). Delirium in elderly people. The Lancet, 383(9920), 911-922.

Manini, T. M., Hong, S. L., & Clark, B. C. (2013). Aging and muscle: a neuron’s perspective. Current opinion in clinical nutrition and metabolic care, 16(1).

Fong, T. G., Davis, D., Growdon, M. E., Albuquerque, A., & Inouye, S. K. (2015). The interface between delirium and dementia in elderly adults. The Lancet Neurology, 14(8), 823-832

REPLY 2

Neurological SystemAs human beings age, the cerebral and the nervous system experience natural modifications as they begin to decline. The cerebral framework and the spinal cord get deprived of nerve cells along with their mass, known as atrophy (Xu et al., 2017). The nervous cells begin to convey messages slower than before. Byproducts can accumulate in the cerebrum tissue as the nerve cells disintegrate. This breaking down can cause strange alterations in the cerebrum known as tangles and plaques to begin to develop.The malfunctioning of the nerves may influence an individual’s senses. A fatty brown colored shade termed lipofuscin may likewise form in the nerve tissue. The patient may lose or have diminished reflexes or reduced sensation. This reduction in sensation and reflexes triggers problems with locomotion and an individual’s health. The slowing down of thinking, memory, and thought is a usual phase of aging. These advances are not identical for every human being.Some individuals have numerous adjustments in their nervous and cerebral tissue, other individuals have minimal to no changes. These advances are not ordinarily recognized with the influences on an individual’s capability to think. At the age of 30, an individual’s neurons decrease in quantity, the size and number of neurological cells increase, axons and dendrites start thinning and declining in quantity (Xu et al., 2017). The deviations that transpire in the central nervous system during the aging process are a reduction of the inflow of blood to the brain and a decrease in the brain’s size and weight.As one continues to age, some peripheral neurons depict shrinking of axonal extent, degeneration of myelin sheaths, and mitochondria reduction. The harm may begin due to an increase in the concentration of pro-inflammatory influences in the human body. The maturing body turns out to be less compelling in clearing harmful metabolites, and as the peripheral nerves are hardly managed, this inefficiency can add to peripheral nerve injury. The reduction of myelin eases back the conduction of peripheral nerve driving forces. In healthy patients, this decrease in conductivity leads to a few issues, but in high-risk patients such as those with diabetes, it might intensify to diabetic neuropathy (Wong et al., 2018). Harmed peripheral nerves are not fixed as easily in more seasoned individuals as in their more youthful years. A portion of these nerves are never fixed, and the damage can lead to decreased motor control and sensation.Delirium refers to an abrupt modification in the brain that leads to emotional disturbance and mental confusion. Delirium makes it challenging to remember, pay attention, think, and sleep. Although the cause of delirium is not exact, it is commonly caused by infections, organ failure, or medications. Dementia, on the other hand, is a loss of memory, problem-solving capabilities, language, and other thinking capabilities that are serious enough to disrupt one’s daily life (Livingston et al., 2020). Dementia occurs as a result of loss or damage of nerve cells and the links with the brain. Both dementia and delirium get attributed to confusion, hallucinations, impaired memory, and disorientation. The difference between the two is that delirium is a result of drug toxicity or acute illness and is usually reversible. Moreover, dementia is caused by anatomical changes in the brain and is usually irreversible.

ReferencesLivingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/s0140-6736(20)30367-6.  (Links to an external site.)Wong, J. C., Walsh, K., Hayden, D., & Eichler, F. S. (2018). Natural history of neurological abnormalities in cerebrotendinous xanthomatosis. Journal of Inherited Metabolic Disease, 41(4), 647–656. https://doi.org/10.1007/s10545-018-0152-9.  (Links to an external site.)Xu, X., Wang, B., Ren, C., Hu, J., Greenberg, D. A., Chen, T., Xie, L., & Jin, K. (2017). Age-related Impairment of Vascular Structure and Functions. Aging and Disease, 8(5), 590.

250 words for each

Introduction and Humanities Knowledge Check

Instructions:

As a way of introducing yourselves to the instructor and your peers, please post the following:

• Your name and a description of your current position (If not employed, what are your expectations when you complete your program?)
• How do you see yourself applying knowledge from this course?
• Post a photo of yourself (self-portrait, family, or action photo)

Answer the following questions:

• Why do colleges require students to study the humanities?
• How do the elements of humanities define the arts and philosophies present today?
• How can you use your study of the humanities to build the soft skills that employers are looking for in today’s job market?

Please be sure to validate your opinions and ideas with citations and references in APA format.

Instructions:

Please post 1 peer response

In the response post, include the following:

• Share one benefit you may experience professionally because you are studying The Humanities.
• How have you needed to demonstrate soft skills in your current employment or in school?
• What would you most like to learn from this course?

Please be sure to validate your opinions and ideas with citations and references in APA format.

Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to input words they feel best describe their team or their role. A “word cloud” is generated by the application that makes prominent the most-used terms, offering an image of the common thinking among participants of that role.

What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?

Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policy-making has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare legislation.

To Prepare:

• Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
• Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.

By Day 3 of Week 8

Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.

By Day 6 of Week 8

Respond to at least two of your colleagues’* posts by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.

*Note: Throughout this program, your fellow students are referred to as colleagues. Everything should be in APA 7 formart. At least 3 references all  with DOI number and at least 3 paragraphs for mainpost and 2 for replies.’

Discussion for reply one  (Guy)

 RNs and APRNs have crucial roles in health care to inform decisions of policy making. There are many opportunities that exist for nursing professionals to participate in policy making. According to Burke (2016), “It’s essential that policies exist that define and integrate appropriate standards for delivery of care and address conditions necessary for that care to occur. Through policy work, nurses can and should influence practice standards and processes to assure quality of care. Nurses who influence policy help share the care that will be provided today and tomorrow. Policies also impact resource allocation to support delivery of healthcare”. 

                 One opportunity that exists for nurses to become active in policy making is to become a member of the American Nurses Association. According to Catallo, Spalding, & Haghiri-Vijeh (2014), “Policy products that the ANA offers include a “policy activist took kit”. As part of this took kit, RNs are provided with resources that include how to get involved in a political campaign, writing letters to the editor, how to engage politicians and carry out lobbying activities”. The article “Nursing Professional Organizations: What Are They Doing to Engage Nurses in Health Policy?” discusses how nurses can become engaged in health policy activities and how to address policy issues. 

                  Another opportunity that exists for nurses to become active in policy making is to advance their education by becoming an APRN. According to Regis College (n.d), “Nurse practitioners have an opportunity to serve as advocates for patients, families, communities, other nurses, and health care organizations. Through this advocacy, nurse practitioners can influence health care policy. By gaining a comprehensive understanding in particular areas of health care, nurse practitioners are uniquely situated to support positions that will benefit out communities”. Becoming an APRN prepares your ability to participate in advocacy of health care policy making.

                  A strategy that can be used to promote nursing professionals involvement in policy making is to do so through nursing employers. For example, I would propose to create and implement a “Policy Committee” through my hospital organization to discuss the potential nurse advocacy benefits we can offer to policy making. In addition, as mentioned by Catallo et al,. (2014), to convey “Political awareness and understanding of the importance of being involved in nursing organizations, time to engage in policy development outside of nursing work, and resources to develop skills in policy participation”. 

                   Another strategy that can be implemented to overcome to barriers of nursing involvement in policy making is to do so through nursing education. According to Short (2008), “The foundations for a professional understanding of health care policy should be well laid in formal education and synthesized with practice and work environments. Without time to promote synthesis of policy concepts related to the practice environment, nurses have no basis for further exploration and may remain naive to the influences of policy throughout their career”. If nursing students (RN or APRN) were exposed to health care policy and the influence their roles can have on policy making during their nursing education, there would be much more nursing involvement in health care policy that is needed today. 

References 

Burke, A. (2016). Influence Through Policy: Nurses Have a Unique Role. Retrieved October 18, 2020 from https://nursingcentered.sigmanursing.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role.

Catallo, C., Spalding, K., & Haghiri-Vijeh, R. (2014). Nursing Professional Organizations: What Are They Doing to Engage Nurses in Health Policy? SAGE Open. https://doi.org/10.1177/2158244014560534

Regis College (n.d). How Does Nursing Influence Health Care Policy? Retrieved October 18, 2020 from https://online.regiscollege.edu/blog/how-does-nursing-influence-health-care-policy/

Short N. M. (2008). Influencing health policy: strategies for nursing education to partner with nursing practice. Journal of professional nursing: official journal of the American Association of Colleges of Nursing. 24(5), 264–269. https://doi.org/10.1016/j.profnurs.2007.10.004

Discussion for reply two(Megan)

“The design phase of the policy process is the point at which the original intent of a solution to a problem is understood and the appropriate tools are employed to achieve policy success” (Milstead, 2019). The creation of policies, or presenting your idea, is how nurses can participate in policymaking. Actively working in the nursing field can help nurses see problems that arise and a better solution to patient needs. Bringing these ideas to congress to make changes will benefit the need of the patients. “Nurses’ influence in health policies protects patient safety, increases quality of care, and facilitates their access to the required resources and promotes quality health care” (Arabi et al., 2014).

Advocacy is another way that nurses can participate in policymaking. “We have been patient advocates in our interactions with doctors and administrators, why not with Congress“ (L. Phillips, 2020). Nurses should feel excited and empowered that they get to have a voice in the political world to make healthcare changes. Advocating for our patients is our duty, and I cannot think of a better way to do this than policy creation or changes. “As a component of professional nursing, active participation in the policy process is essential in the formulation of policies designed to provide quality health care at sustainable costs to all individuals” (Milstead, 2019).         

Some of the challenges nurses face when getting involved with policymaking are getting push back from legislators and finding the evidence-based practice to support ideas. Nurses must band together and fight for what we know is right and what our patients need. Becoming an active member of a nursing organization can help support new policies or change old policies. Support strength comes in numbers. Having multiple people that share the same ideas will decrease pushback. Finding evidence-based practice to support our ideas may pose a problem, but putting in work to find or create research will be worth it, in the end, to help our patients with new or changed policies. Also, becoming a member of a nursing association can assist with finding or creating evidence-based practice.

The strategies I think will help advocate for these opportunities is being involved in a nursing association and providing courses like this to nurses. I know I spoke of nursing associations already, but I cannot think of a better way to come together and share our similar experiences and ideas to improve processes and policies to assist our patients. Providing courses like this to help educate nurses and get them involved in politics helps drive home the importance of our voices.

References

Arabi, A., Rafii, F., Cheraghi, M., & Ghiyasvandian, S. (2014, May 19). Nurses’ policy influence: A concept analysis. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061635/

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning. Pg.  97

 Phillips, R. (2003). Health Care Policy: The Nurse’s Crucial Role. American Academy of Ambulatory Care Nursing. https://www.aaacn.org/volunteer/teams/legislative/health-care-policy-nurses-crucial-role

As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the South University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.
• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template

TASK

Post your initial response to one of the two topics below.

Topic 1:  Causes of Death

Using the CDC website, conduct a search to compare the causes of death among two ethnicities of the same age or two different ages of the same ethnicity.

Topic 2:  Responsibilities of a Nurse

Discuss the following with regard to the role and responsibilities of a nurse in a community:

• How are the roles of the BSN and the advanced practice nurse in community health different?
• How are nurse practitioners utilized in your community?
• Do they increase access to health care or work for physicians?
• What are the requirements for nurse practitioners in your state?
• What privileges do they have that general nurses do not have?
• Justify your responses using resources

I need these questions answered in 150 words each with individual references

Surveillance Data
 

1. If you work in the health care field please provide an example of surveillance data that you or your agency/department/office submits to local, state, or federal agencies. If you do not work with these directly, can you locate an example? If possible, also please include how often a report is submitted and how the information is used.
 

Looking forward to hearing from you,

3-D Mammography

2. Thank you for discussing validity and sensitivity of mammograms, Doreen.
 

Many women (43% of women ages 40 to 74 years), myself included, have dense breast tissue which makes identifying abnormal tissue more difficult (Breastcancer.org, 2016). Some solutions include using 3-D mammography or breast ultrasound for regular screening since they can detect more cancers in dense breasts (Breastcancer.org, 2016). These tests can help prevent false-positive tests, which is when a screening test finds an area that looks like cancer but turns out to be normal (Breastcancer.org, 2016).
 

I have had false positive tests that needed to be repeated, have any of you had any similar experiences?

Reference
 

Breastcancer.org. (2016). Adding 3-D Mammography or Ultrasound to Regular Screening Finds More Cancers in Dense Breasts. http://www.breastcancer.org/research-news/add-3d-mammo-or-ultrasound-to-dense-breast-screening

Mind, body and psychotherapy

3. Well, I have personal confession to make.  Many years ago, my wife an LICSW, did a number of workshops with Jon Kabat Zinn on mindfulness.  Well, I was probably and associate professor at the time heavily committed to quantitative analysis, evidenced based practice and being an all-around hard scientist (i.e, annoying). As a result of which, I condescendingly  ignored what my wife was learning in her mindfulness workshops.  Then years later, did some workshops with Steve Hayes, (ACT) with an number of other ACT practitioners.  I discovered mindfulness!.  My wife was much more forgiving about my new found meaning of mindfulness! (Well, mostly forgiving).

When I work my horse, play tennis, and play music, I practice mindfulness.

The problem with alternative therapies

An Article is Attached

4. As we think about the question posed by this DQ, it is important to think critically about “alternative therapies”. 

The opening line of the attached article on pseudoscience and psychiatry is:

“As Nobel prize-winning physicist Richard Feynman reminded us, “the first principel is that you must not fool yourself, and your are the easiet person to fool.”

Psychology and particularly psychotherapy has historically been plagued by pseudoscientific therapies and charlatans. Our job as scientists is to think critically and separate the wheat from the chaff.

Your thoughts?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4679160/pdf/cjp-2015-vol60-dec2015-531-533.pdf

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

1. Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
2. Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
3. Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
4. Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
5. Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
6. Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

Prepare this assignment according to the guidelines found in the APA Style Guide

In this mid-course entry into your Nurse E-Portfolio for this course, you will be examining your perceptions of the nurse in the role of collecting and assessing information. Using the e-portfolio format, answer the following questions. Make sure you spend some time thinking about the answers to these questions before writing.

1. What have you learned so far in this course that will help you conduct effective health assessments?
2. What skills do you have you gained?
3. Describe any areas that are still unclear and ways you will gain clarity.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below

PLEASE FOLLOW ALL INSTRUCTIONS IN THE UPLOADED DOCUTMENT!!!

In this assessment, you will evaluate the physicians’ practice financial condition based on the following Relative Value Unit (RVU) calculations and analysis:

1. Average and Marginal Costs per RVU,
2. Total Average Cost,
3. Total Marginal Cost per CPT code, and
4. Analyzing the information to assist the physicians in using these costs appropriately and making informed decisions.