#1)  Write down sample nursing diagnoses, interventions, and expected outcomes for the following client:

Elaina, 27 years old, visits a prenatal clinic to confirm a positive pregnancy test. Elaina tells the nurse that she is not married and has no support system. She also states that she is making minimum wage at a restaurant with no health insurance and cannot afford prenatal care. She intends to keep the baby and would rather not tell her partner because “they don’t have that kind of a relationship.” Elaina asks the nurse “If I take good care of myself, why do I need prenatal care?”

#2) Explain how the fetus is affected by tobacco use during pregnancy.  Keeping in mind the 2020 National Health Goals, what are some things you can do as a nurse to promote these goals and carry your ideas out into the community.

#3) You are asked to perform an assessment of a pregnant  woman and her family. Prior to the assessment, devise a list of interview questions to use to assess the woman’s readiness for parenthood and current health status as well as her goals for the pregnancy.

#4) For each of the following QSEN competencies write a list of nursing interventions for promoting fetal and maternal health related to each competency:

         Patient centered care

        Teamwork and collaboration

         Evidence-based practice

        Quality improvement

         Safety

         Informatics.

#5)  List the four major hormones produced in early pregnancy.  Describe what each one does.

Scenario

The United States continues to experience challenges with respect to health reform. There is considerable agreement on the need for health reform; however, there is an appreciable divide with respect to how to best achieve reform. Discussions on strategies for reform include a repeal of current legislation (the ACA), the implementation of a universal plan, and various “fixes” to the ACA.

Many would suggest that a repeal of the current system would be most appropriate, while others support efforts to “fix” the current ACA. The health organization you work for has asked you to develop a comprehensive proposal for healthcare reform.

The U.S. expends more of its Gross Domestic Product on healthcare than any other developed nation. However, the superior amount of spending has not resulted in superior outcomes when compared to other countries. In addition to higher costs, the U.S. is the only developed country that does not offer universal health to its citizens. There has been a significant amount of discourse with respect to the pros and cons of universal coverage. Those who oppose universal coverage often refer to the Canadian, single-payer system and its challenges, such as high tax liabilities for citizens, its long wait times, and the perception of the single payer system as socialized medicine. However, those in favor of universal coverage argue that the single payer system is not socialized medicine and its costs relative to the current system in the U.S. is more cost effective. Moreover, the single payer system is only one form of universal coverage. Countries that consistently rank high in terms of positive health outcomes often employ a multi-payer universal system as opposed to a single-payer system.

Instructions

You will analyze the current literature on the health system in the U.S. Your final project will include a paper, a voiceover PowerPoint presentation, and an infographic of your proposed solution. Possible solutions include a single payer universal plan, a multi-payer universal plan, a potential enhancement to the ACA such as adding a public option, Medicare for all, or a complete repeal of the current law.

The three (3) deliverables are:

1. A paper that includes the challenges facing the U.S. in terms of balancing the iron triangle of health – Costs, Access, and Quality. Please address the following:
   1. An examination of current policy
   2. A discussion of whether healthcare should be considered a right or a privilege
   3. A discussion of the role of special interest groups on health reform
   4. Articulate the significance of the involvement the Congressional Budget Office in determining the cost effectiveness of reform
   5. Explain the importance of considering existing privacy laws in reform efforts
   6. Describe and justify your potential solution to current challenges facing the U.S., including resource allocation
2. A voiceover PowerPoint presentation that summarizes the major challenges facing the U.S. in terms of balancing the iron triangle of health, a comparison of various possible solutions, and your proposed solutions.
3. An infographic that outlines your final proposed solution to the current challenges facing the U.S. in terms of balancing the iron triangle of health.

Needs to be at least 250 words with at least 1 scholarly article within the past 5 years.  No plagiarism.  Due tomorrow.

There is much written about implementation fidelity in the design and implementation phases of a practice change project.  What does implementation fidelity mean and how does it influence the translation of a research-proven intervention in your future practice change project? 

As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.

Photo Credit: Getty Images/Ingram Publishing

Week 1: Basic Pharmacotherapeutic Concepts/Ethical and Legal Aspects of Prescribing

How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow?

Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat.

This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors.

Learning Objectives

Students will:

• Analyze factors that influence pharmacokinetic and pharmacodynamic      processes in patients
• Assess patient factors and history to develop personalized plans of      care
• Evaluate ethical and legal implications related to prescribing      drugs
• Analyze ethical and legal practices of prescribing drugs
• Analyze strategies to address disclosure and nondisclosure
• Justify advanced practice nurse strategies to guide prescription      drug decision-making
• Analyze the process of writing prescriptions to avoid medication      errors

Learning Resources

Required Readings (click to expand/reduce)

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

· Chapter 1, “Prescriptive Authority” (pp. 1–3)

· Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)

· Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)

· Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)

· Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)

· Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767

American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

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

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

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

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration.

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

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

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

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

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

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

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

Required Media (click to expand/reduce)

Discussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.

Photo Credit: Getty Images/Ingram Publishing

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare

• Review the Resources for this module and consider the principles of      pharmacokinetics and pharmacodynamics.
• Reflect on your experiences, observations, and/or clinical      practices from the last 5 years and think about how pharmacokinetic and      pharmacodynamic factors altered his or her anticipated response to a drug.
• Consider factors that might have influenced the patient’s      pharmacokinetic and pharmacodynamic processes, such as genetics (including      pharmacogenetics), gender, ethnicity, age, behavior, and/or possible      pathophysiological changes due to disease.
• Think about a personalized plan of care based on these influencing      factors and patient history in your case study.

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

At Least 3 citations with 7th edition APA Format

Assignment: Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

Photo Credit: Getty Images/Caiaimage

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

• Review the Resources for this      module and consider the legal and ethical implications of prescribing      prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by      your Instructor for this Assignment.
• Search specific laws and standards      for prescribing prescription drugs and for addressing medication errors      for your state or region, and reflect on these as you review the scenario      assigned by your Instructor.
• Consider the ethical and legal implications      of the scenario for all stakeholders involved, such as the prescriber,      pharmacist, patient, and patient’s family.
• Think about two strategies that      you, as an advanced practice nurse, would use to guide your ethically and      legally responsible decision-making in this scenario, including whether      you would disclose any medication errors

Write a 3-page paper that addresses the following:

• Explain the ethical and legal implications of the scenario you      selected on all stakeholders involved, such as the prescriber, pharmacist,      patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as      identified in the scenario you selected. Be sure to reference laws      specific to your state.
• Explain two strategies that you, as an advanced practice nurse,      would use to guide your decision making in this scenario, including      whether you would disclose your error. Be sure to justify your      explanation. 
• Explain      the process of writing prescriptions, including strategies to minimize      medication 

At Least 3 citations using 7th edition APA format

PATIENT POPULATION: 

The student will describe the patient population that is impacted by the clinical issue. With a focus on the diversity of the human condition found within this patient population, the student will describe the influence that cultural values may have on the proposed solution.  

Summarizes the diversity of the human condition found within the patient population.  Identifies the influence that cultural values may have on the plan for addressing the clinical issue. 

PROPOSED SOLUTION:

 The student will set the stage for proposing the best solution to the clinical problem by using appropriate evidence-based data and integrating data from peer-reviewed journal articles. In this paper, the student will: 

i. Propose a clear solution to the clinical problem that is supported by a minimum of three scholarly, peer-reviewed journal articles. 

ii. Expand on the ethical considerations when developing the plan for addressing the issue affecting patient population. 

REFLECTION # 1  question has 2 parts. Please do not repeat what was stated before, however you can add a different point.

2. (a) Name at least one nurse legislator and (b) name the state affiliated.

APA Format and turniting report, 250 words. miami florida state 

PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:

1). ZERO (0) PLAGIARISM

2). ATLEAST 5 REFERENCES, NO MORE THAN 5 YEARS

3). PLEASE SEE THE FOLLOWING ATTACHED RUBRIC DETAILS. 

Thank you.  

Nursing is a very highly regulated profession. There are over 100 boards of nursing and national nursing associations throughout the United States and its territories. Their existence helps regulate, inform, and promote the nursing profession. With such numbers, it can be difficult to distinguish between BONs and nursing associations and overwhelming to consider various benefits and options offered by each.

Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice. Understanding these differences helps lend credence to your expertise as a professional. In this Assignment, you will practice the application of such expertise by communicating a comparison of boards of nursing and professional nurse associations. You will also share an analysis of your state board of nursing.

To Prepare:

· Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.

· Review the NCSBN and ANA websites to prepare for your presentation.

The Assignment: (8- to 9-slide PowerPoint presentation)

Develop an 8- to 9-slide PowerPoint Presentation that addresses the following below:

· Describe the differences between a board of nursing and a professional nurse association. 

· Describe the board for your specific region/area.

o Who is on the board?

o How does one become a member of the board?

·   Describe at least one state regulation related to general nurse scope of practice.

o How does this regulation influence the nurse’s role?

o How does this regulation influence delivery, cost, and access to healthcare?

·  

· Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).

o How does this regulation influence the nurse’s role?

o How does this regulation influence delivery, cost, and access to healthcare?

· Include Speaker Notes on Each Slide (except on the title page and reference page)

Please, Submit your Regulation for Nursing Practice Staff Development Meeting Presentation.

• Meiner, S. E., & Yeager, J. J. (2019).
  • Chapter 17
    Chapter_017.pptx
  • Chapter 18
    Chapter_018.pptx
  • Chapter 19
    Chapter_019.pptx
  • Chapter 20
    Chapter_020.pptx

Watch

None.

Supplemental Materials & Resources

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

1. O’Keefe-McCarthy, S. (2009). Technologically-mediated nursing care: The impact on moral agency. Nursing Ethics, 16(6), 76-796.
2. Teutsch, S., & Rechel, B. (2012). Ethics of resource allocation and rationing medical care in a time of fiscal restraint: US and Europe. Public Health Reviews, 34(1), 1-10.

QUESTION

• Define presbycusis, name signs and symptoms, etiology and differential diagnosis.
• Create 3 interventions-education measures with a patient with Presbycusis.
• List, define and elaborate on three different retinal and macular diseases age-related.

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

Your assignment will be graded according to the grading rubric.

See attachments.

Consider the following topics. In many U.S. communities, low-income populations use the emergency room instead of going to a physician or mid-level provider’s office. They often do not pay the bill for their service, which shifts the cost of their care to other, paying patients at the hospital. This practice drives up the cost of health care, but what else can hospitals do? They have to have a certain amount of income to keep their doors open. Is this fair? What if these sick people remain untreated and infect others? Is this just? Do they deserve care so that they don’t infect others? We talk about a culture of poverty in this country. What does this mean to you? What about those people who seem to bilk or misuse the health care system? Do they deserve care? If so, who should pay for it? Shouldn’t everyone be forced to carry health insurance so that everyone has a pay source? Can we expect people to pull themselves up by their bootstraps?

To prepare for this Discussion, you will need to read the assigned chapters, and then consider the following questions:

• What does social justice mean to you? Is social justice the same as socialized medicine or even communism?
• The notion of social justice is fairness so that everyone can achieve a certain level of health and wellness. After all, the Constitution guarantees everyone the right to pursue happiness. Is the health care system fair?
• If you could wave a magic wand and fix the health care system, what is the first thing you would notice indicating that it had changed? Or, in your opinion, do you think it needs to be changed at all?

Support your response with references from the professional nursing literature.

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).