How has the U.S.A risen to the top internationally to decrease abuse amongst pregnant women?   

 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.

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 the pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain the 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.

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

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
 

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

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
 

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

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

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s
Note: This media program is approximately 14 minutes.

 PLEASE FOLLOW INSTRUCTION BELOW

4 REFERENCES 

ZERO PLAGIARISM

As the population continues to age, more and more older adults will require therapy for various mental health issues. While the group setting offers many benefits and makes therapy more accessible to those in need of services, this therapeutic approach may not be effective for all clients. For this Discussion, as you examine your own practicum experiences with older adults in group therapy settings, consider strategies to improve the effectiveness of your sessions.

Learning Objectives

Students will:

• Analyze group therapy sessions with older adults
• Recommend strategies for improving the effectiveness of group therapy sessions for older adults

To prepare:

• Review this week’s Learning Resources, and consider the insights provided on group therapy with older adults.
• Reflect on your practicum experiences with older adults in group therapy settings.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post a description of a group therapy session with older adults, including the stage of the group, any resistances or issues that were present, and therapeutic techniques used by the facilitator. Explain any challenges that may occur when working with this group. Support your recommendations with evidence-based literature.

Discussion: Community Mobilization

Previous Next 

Throughout the term we have discussed various components of strategic planning. One of the key components to successful community programs is mobilization.

• Discuss the role of community mobilization.
• Additionally, discuss the role of the following individuals/groups in community mobilization.
  • Students whose last name begins with A-G should discuss the role of public health workers.
  • Students whose last name begins with H-N should discuss the role of coalition members.
  • Students whose last name begins with O-T should discuss the role of program developers.
  • Students whose last name begins with U-Z should discuss the role of religious leaders.

Looking for a Walden University HE007 paper

Benchmark – Nursing Process: Approach to Care

The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.

Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:

1. Describe the diagnosis and staging of cancer.
2. Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
3. Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
4. Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
5. Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
6. Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.

You are required to cite to a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

1) Minimum 7 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

              Part 1: Minimum 3 pages

              Part 2: minimum 1 page

              Part 3: minimum 3 pages

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

               Part 1: Minimum 5 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: Pathopisyology

Topic:  CVA 

2 pages:

1.A discussion of the pathophysiology of the disease, including signs and symptoms.

2. An explanation of diagnostic testing and rationales for each.

3. A review of different evidence-based treatment modalities for the disorder obtained from guideline.gov or a professional organization.

1 page:

4.How does the information in this case inform the practice of a master’s prepared nurse?

5. How should the master’s prepared nurse use this information to design a patient education session for someone with this condition?

6. What was the most important information presented in this case?

7. What was the most confusing or challenging information presented in this case?

8. Discuss a patient safety issue that can be addressed for a patient with the condition presented in this case.

Part 2: Policy Organization and Financing Healthcare

1. Demonstrate your AGAINST position about the the promise of guaranteed health care coverage for all 

2. Explain why you are AGAINST

Part 3: Policy Organization and Financing Healthcare 2

  Maternal Health and Mortality 

Topic: “The House Ways and Means Committee convened a hearing to discuss the high rate of mothers dying due to causes related to pregnancy or childbirth in the U.S. Olympian and gold medalist track and field athlete Allyson Felix testified about the need to address the racial disparities with maternal health care” (“House Committee Examines Racial Disparities in Maternal Mortality Rates”, n.d.).

Location: May 16th, 2019 @ C-Span.org

Link: https://www.c-span.org/video/?460809-1/house-committee-examines-racial-disparities-maternal-mortality-rates&start=1692&transcriptQuery=nicu

1. The purpose of the meeting, key participants, key agenda items, and meeting logistics

2. Background information and a description about the committee

3. One specific topic that was discussed at the meeting and an explanation of the committee process

4. An analysis of the key stakeholder positions related to the topic discussed

5. Key interactions that occurred at the meeting

6. Outcomes of the meeting including the specific topic focus

Mrs. J is repeatedly asking for a nurse; other patients are complaining, and you simply cannot be available to Mrs. J for long periods.  Considering the setting and the OBRA guidelines, what would you do to manage the situation?

Reply to this discussion post 

Understanding the health care system at a local level is important when researching evidence-based practice. Determining the needs and perceptions of a population that are being studied and attempted to change is an important factor. If the local area that is being researched is rural, resources will be limited to health care. If urban areas are being researched, there are more resources and populations to consider. If the health care system issues are not of interest or don’t apply to areas, then they are less likely to be supported for change. The United States health care system continues to struggle and “our nation struggles with persistent health disparities and rising health care costs, nurses have a moral obligation to shape health and social policy in ways that will advance the health and well-being of the public” (Mason, 2016). Nurses can continue to bring crucial perspectives to promote safety and healthy well being to our communities and neighborhoods. 

     Working with my preceptor, one of Adventist Health Sonora uses redesign projects that call for a pre-op nurse navigator to coordinate evidence-based practices for optimization of the pre-op patients like BMI, smoking, diabetes. The position is not held so working on ways to accomplish pre-op optimization in a way that patients are still getting these practices. A care redesign example is for care of patients with cellulitis/soft tissue injury and the algorithm includes consulting with an on-call podiatrist and/or limb salvage center and that position is not held so this has been adapted by the Wound care team for consults. 

     Increasing one’s knowledge about communities and health disparities can be accomplished in many ways. Understanding the needs of the local levels can increase the ability to care for patients of these populations.

REPLY1

Being that Ms. Alma Faulkenberger is 85 years old, she has most likely had many interactions with healthcare staff that may have led to her this non-compliant, difficult way of thinking. “A participatory relationship between patient and physician appears to be the most important factor promoting medication adherence” and that “the more actively the patient is involved, the higher the level of adherence and the greater the chance that the patient engages in healthy diet and exercise behaviors” (Kleinsinger, 2010). Research has shown that open communication, quick responses and creating a trustworthy relationship will help the patient remain compliant with their plan of care.

I would start my interaction by introducing myself, apologizing and asking her how to pronounce her name. Then to develop a plan for Ms. Alma to be compliant with the procedure and post-treatment, it is important to assess her needs, and include her in the planning. Opening the floor with open ended questions and allowing her to voice her opinions and needs/wants is a method that enables her to feel included in the plan of care. I would use this time to discover any barriers in learning such as difficulty hearing, unable to read, living situations and needs at home. I would ask how she learns best, reading, written or demonstration. After assessing her and asking her questions, I would then use what I discovered to implement education. I would ask her to teach back what she has learned. It would be best if this teaching were done with a family member to help with coherence to the plan.

Kleinsinger F. (2010). Working with the noncompliant patient. The Permanente journal, 14(1), 5

REPLY2

To help Alma be compliant with the invasive pelvic procedure and post-treatment medication, the health care professional must develop a plan. The first step is providing therapeutic communication. Explaining the logic behind the plan, understanding the patient perceptions of the treatment and procedure, and talking about any problems with the post-treatment plan is important to have an effective plan (Falvo, 2011). Asking her about her family and other significant people can help aid in the education efforts as well. Being specific and providing printed handouts can help with the higher level of education needed for an extensive procedure and treatment. Being a positive influence on patient adherence is a great skill of health providers to have. Building a relationship should also be part of the health professionals plan to assist in Alma being successful in procedure and post-op treatment. 

Then, another step in the plan should be to meet the patients individual needs, if that patient wants to go biking again, we can work with her to ensure she can do that in 6 weeks after post-op for example and maybe collaborate with PT/OT to get here there. Same with finding out a medication regimen that works best for her every day life, if she has a book club at 10am every Wednesday, but you ask her to take it at 10am she may skip doses. The plan should be holistic and use communication and creating a relationship with the patient for it to be successful. Meeting the individuals needs with their strengths and being aware of weaknesses is also important. In patient education, the health professional should talk calmly, clearly, and slowly. Providing follow up questions and really taking the time to listen to Alma is very important. Using all of this into the plan of care, Alma’s pelvic procedure and post-treatment medication should be successful. 

Falvo, D. R. (2011). Effective Patient Education: A Guide to Increased Adherence. Retrieved from https://viewer.gcu.edu/RQBKXW