Searching Databases

 When you decide to purchase a new car, you first decide what is important to you. If mileage and dependability are the important factors, you will search for data-focused more on these factors and less on color options and sound systems.

The same holds true when searching for research evidence to guide your clinical inquiry and professional decisions. Developing a formula for an answerable, researchable question that addresses your need will make the search process much more effective. One such formula is the PICO(T) format.

In this Discussion, you will transform a clinical inquiry into a searchable question in PICO(T) format, so you can search the electronic databases more effectively and efficiently. You will share this PICO(T) question and examine strategies you might use to increase the rigor and effectiveness of a database search on your PICO(T) question.

To Prepare:

  • Review the materials offering guidance on using databases, performing keyword searches, and developing PICO(T) questions provided in the Resources.
  • Review the Resources for guidance and develop a PICO(T) question of interest to you for further study.

Post your PICO(T) question, the search terms used, and the names of at least two databases used for your PICO(T) question. Then, describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.

Musculoskeletal case study

Read chapter 40: Musculoskeletal Systems Function

The nurse in the outpatient orthopedic clinic is reviewing the medical records of several patients being seen in the clinic today. In the most recent note by the provider, the nurse reads the following:

‘A 67-year-old, moderately obese woman examined today for increasing back and left shoulder pain. Limited circumduction of left arm noted in comparison with right arm. Strength of left arm is less than right, with less muscle definition in the left arm. Examination of back indicates significant kyphosis, and the patient states that she is ‘shrinking.’ Bone density testing of the hip is ordered.”

1. How does the nurse interpret “limited circumduction”
2. When the patient arrives, the nurse correlates the “kyphosis” with what physical finding? What causes kyphosis in the older adult?
3. How should the nurse explain the patient’s decreasing height?
4. What is the rationale for ordering bone density testing of the hip in this patient?

DO NOT EMAIL ASSIGNMENTS. PLEASE UPLOAD ALL ASSIGNMENTS TO CANVAS. LATE ASSIGNMENTS WILL NOT BE GRADED!!! PLEASE PROVIDE REFERENCES FOR  ALL  WRITTEN ASSIGNMENTS!!!

Advance health assessment

To prepare:

  • Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
  • By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
  • Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
  • Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
  • Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
By Day 3 of Week 2

EB is a 68-year-old black female who comes in for follow-up of hypertension. She has glaucoma and her vision has been worsening during the past few years. She lives alone and is prescribed four hypertension medications (Hydralazine 50 mg PO Q8H, Metoprolol XL 200 mg PO Q12H, Lisinopril 40 mg PO daily, and HCTZ 25mg PO daily ). She brings in her medication bottles and she has some medication bottles from the previous year full of medications. She is missing one medication she had been prescribed and says she may have forgotten it at home. Her BP in clinic today is 182/99 with HR of 84.


Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Evidence based project presentation

 

Create a professional presentation of your evidence-based intervention and change proposal to be disseminated to an interprofessional audience of leaders and stakeholders. Include the intervention, evidence-based literature, objectives, resources needed, anticipated measurable outcomes, and how the intervention would be evaluated. Submit the presentation in LoudCloud for feedback from the instructor.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

peer response

In the response post, critique the outline by providing strengths and areas of improvement based on the quality of the following:

  • Introduction
  • Body w/ transitions
  • Conclusion
  • Supporting materials – in-text references and APA citations
  • Were you informed? How was it or was it not effective?
  • Other suggestions for improvement
  • Any suggestions you have for smoothing out the content.

Peers’ post:

Opioid use in Pregnancy and effects on Child later in life

Specific Purpose:   The effects of opioid use on the fetus in pregnancy and effects of opioid use on the child later in its life.

Central Idea:   To educate women on the serious effects of opioid use during pregnancy and how it can potentially affect the child.

INTRODUCTION

I. (Attention Getter) “According to 2019 self-reported data, about 7% of women reported using prescription opioid pain relievers during pregnancy. Of those, 1 in 5 reported misuse of prescription opioids, defined as getting them from a non-healthcare source or using them for a reason other than to relieve pain.” (cdc, 2020)

II. (Reveal Topic) We are going to be discussing about the effects on a fetus born to a woman who used opioids during pregnancy and what effects it may bring to the child when they are born.  

III. (Credibility Statement)

According to the CDC, ‘an estimated of 14%-22% of women filled an opioid prescription during pregnancy.’ And according to a 2016 data from the Healthcare Cost and Utilization Project, 7 newborns born out of every 1,000 newborns hospital stays, were diagnosed with Neonatal abstinence syndrome (NAS). NAS is a group of condition in which results when a newborn withdraws from certain drugs, most commonly opioids where he was exposed to in his mother’s womb before birth.

IV. (Preview) NAS may lead to long-term health and developmental problems for the child that may include hearing, vision and learning and behavioral problems later for a child born with NAS. NAS is most often caused when a woman takes opioid drugs in pregnancy but can also be caused by other medications such as antidepressants, barbiturates, or benzodiazepines. These drugs can pass through the placenta causing serious problems for the baby. The placenta grows in the uterus with pregnancy and supplies the baby with nutrition and oxygen through the umbilical cord. 

Transition: Drug use during pregnancy is an important pregnancy teaching topic. Especially for women who uses opioids and other medications. Patient education on the long term effects of opioid use on the child is an important matter to discuss with the expecting mother so ensure she understands the consequences that may come with using opioid during pregnancy. 

Body

(Main Point 1) Effects of opioid use in pregnancy.

A. (Subpoint) Opioid use in Pregnancy 

The effects on pregnancy in a woman using opioid drugs during pregnancy.  

a. In 2019, about 7% of women reported to using a prescription opioid pain reliver during pregnancy. 1 out of 5 women reported misuse (getting them from another source other than a healthcare provider) using them for other reasons other than to relieve pain 

b. Maternal death. About 700 women due each year in the United States from pregnancy or delivery complications.  

c. Stillbirth 

  • Tobacco use—1.8 to 2.8 times greater risk of stillbirth, with the highest risk found among the heaviest smokers
  • Marijuana use—2.3 times greater risk of stillbirth
  • Evidence of any stimulant, marijuana, or prescription pain reliever use—2.2 times greater risk of stillbirth
  • Passive exposure to tobacco—2.1 times greater risk of stillbirth 

Next, we will discuss about the long-term effects of opioid use on a child.

(Main Point 2) Effects on Child 

Opioid use during pregnancy and its effects on a child born with NAS. 

a. A child born with NAS may show symptoms within 72 hours/3 days of birth. 

b. Signs of NAS can vary for each baby

TRANSITION: Now we will talk about complications of NAS on a baby

NAS complications on the baby  

a. Signs and symptoms to look for in a baby with NAS  

Signs and symptoms to look for in a baby with NAS  

a. Tremors, convulsions, seizures, over reactive reflexes, fussiness, excessive crying, poor feeding, slow weight gain, breathing problems, fever……………. 

b. Complications: low birth weight, jaundice, sudden infant death syndrome. 

Long term Effects on Child 

a. developmental delays

b. Child may not reach developmental milestones— sitting, walking, talking, social and thinking skills.

c. Motor problems 

d. Speech and language problems 

e. Sleep problems 

f. Ear infections

g. Vision problems 

Conclusion

Patient education on the potential dangers of opioid use during pregnancy is vital to a healthy pregnancy and baby. Informing an expecting mother on the potential complications of using opioids during pregnancy can help to avoid these complications in both pregnancy and the newborn. Its important for a mother to understand the signs of possible NAS in their baby as these signs can present a little later after birth. Most babies born with NAS who receive proper treatment right away get better in 5-30 days.

(Summary Statement) Importance to seek medical attention right away if pregnant and using an opioid medication. Patient education is important in informing an expecting woman about the potential complications that may come with continuing use of opioids during pregnancy and what complications it may cause for the newborn when they are born. Avoiding a baby being born with NAS could be avoided with early detection and planning.

(Memorable Closing Statement) Patient education is a significant part of a healthcare providers job. Patient education may improve a patients health status. When patients are involved in their care, patients are more likely to engage in interventions that may increase their chances of positive outcomes.

Discussion Question

1- Discussion question: Describe nursing-sensitive measurements and why they are important in Nursing care delivery. 

2- 3 paragraphs 3 sentences each.

3- 2 references not older than 2015

4- APA style

Neurological case study

 

Below is the Neurology case study for this week. Please write a 2-4 page paper (in APA format) discussing generalized seizures versus focal seizures. Be sure to follow the case study rubric located under “Important Course Information.”

Use the following items as headings for your paper:

– Pathophysiology

– Examples of each type of seizure

– Typical EEG findings associated with each seizure

– Physical presentation with each seizure

– Common medications used to treat each seizure type.

This is a formal APA paper so, your in text citations and reference list must be in APA format. Be sure to use proper grammar and punctuation. Be sure to use the headings described above in addition to including an intro and conclusion paragraph. A title page and separate reference page are required.

You  must also use 3 credible resources, i.e textbook, journal articles, credible websites. recent within the last five years

Submit your assignment as a Word document to the correct dropbox.

Teaching project

  Topic: Nutrition and Healthy Eating

Need at-least three credible references 

(Also use this website      https://health.gov/healthypeople/objectives-and-data/browse-objectives/nutrition-and-healthy-eating      as one of the reference)

PROJECT SUBMISSION FORM TO UPLOAD TO CANVAS

Assignment submission MUST not exceed 3 pages. Form can be single-spaced and instructions can be removed if necessary, to allow additional space to record information. An APA style paper with title page, etc. should not be submitted for this assignment.

Student Name: 

PROJECT REQUIREMENTS

1. TOPIC, RATIONALE AND TARGET AUDIENCE: (15 PTS)

a. Topic Selected

b. Rationale/ Why Important today

c. Intended Target Audience 

i. The intended target audience for this topic is the college student. 

1. Discuss 1-2 aspects of the college learner you considered; consider age, gender, developmental stage, culture, etc.

2. 2 SMART LEARNER OBJECTIVES: (15 PTS)

a. Objective #1: 

i. The learner will be able to:

b.  Objective #2: 

i. The learner will be able to:

3. TWO KEY POINTS FROM YOUR TEACHING TOPIC: (30 pts)

This is the most important information you found in your literature review for your topic. These will be included in your teaching session. Your SMART goals were developed from THESE TWO KEY POINTS.

a.  First Key Point:

i. Include In- text citation for information

b.  Second Key Point:

i. Include In-text citation for information

4. Healthy People 2020 (Include 1 item from HP 2020 to support this topic): (10 pts)

a. According to Healthy People 2020, this topic is considered pertinent to overall health because: 

5. Plan for Evaluation: (20 pts)

a. Method to evaluate 2 SMART objectives.

i. How to Evaluate First SMART Objective:

ii. How to Evaluate Second SMART Objective:

6. 2- 4 Scholarly References Listed in APA Format Below. Check for proper grammar, spelling throughout entire form. (10 pts)

a. Textbook, scholarly journal articles which are current- past 5 years, credible professional websites- AHA, AHNA, etc.  

b. Healthy People 2020 website can count as a reference. A variety of references are recommended, but not required.