SEE ATTACHED DOCUMENT FOR INSTRUCTIONS

DUE DATE JANUARY 17, 2025

NO MORE THAN 10% PLAGIO ALLOWED

Question: Does my patient have significant aortic stenosis?

A 72 year-old woman with a history of CHF presents with several weeks of gradually progressive dyspnea on exertion (DOE). At her baseline, she is able to walk several blocks, but now feels winded. She denies chest pain, palpitations, syncope/near syncope, cough, orthopnea, or PND. She states she is compliant with her medications and diet. She has had a recent functional study that showed minimal ischemia.

Meds

aspirin
digoxin 0.125 qd
lisinopril 20 mg qd
furosemide 20 mg qd
KCl 10 mEq qd

PE

HR 90, regular
PB 134/70

Labs

chem 7:
Na 132
K 5
Cl 94
HCO3 30
BUN 18
Cr 1.3
CBC: notable for Hgb 14 g/dL (Hct 43%)

CV

RRR, normal S1 and S2
No S3 but has S4
2/6 mid-peaking systolic murmur at the LUSB that radiates to the carotids.

PMI is mildly enlarged and sustained

Neck

Carotid pulse is brisk.
JVP flat
Positive abdominojugular reflux

CXR

Xray shows cardiomegaly and mild vascular redistribution

ECG

Unchanged with an incomplete LBBB pattern

Clinical Diagnosis

Worsening of her congestive heart failure (positive AJR, enlarged and sustained PMI, cardiomegaly, and vascular redistribution).

Clinical Questions

Is this patient’s worsening CHF due to significant aortic stenosis? 

Please elaborate why you think it may be aortic stenosis according to patient’s symptoms and how do you assess each symptom.

APA style

Discussion Prompt “Lifestyle Changes for Disease Prevention and Management”

• Forum
• Don’t track unread posts

Completion requirements

Discussion Prompt: Lifestyle Changes for Disease Prevention and Management

Overview: Lifestyle modifications play a crucial role in preventing and managing chronic diseases such as cardiovascular disease, diabetes, and obesity. For this discussion, you will explore how lifestyle changes—such as nutrition, physical activity, stress management, and avoiding harmful behaviors—can prevent or modify disease processes and promote restoration of health. (CSLO #4)

Instructions:

1. Choose a Disease Process: Select a specific disease process (e.g., hypertension, Type 2 diabetes, coronary artery disease, chronic obstructive pulmonary disease).

2. Discuss Lifestyle Changes: Describe at least two lifestyle changes that can prevent, modify, or restore health in relation to your selected disease. Use evidence-based practice (EBP) to support your discussion.

o Include specific examples of dietary changes, physical activity, smoking cessation, or stress management techniques.

3. Explain the Impact: Discuss how these lifestyle changes influence the disease process. Explain the physiological or behavioral changes that occur as a result.

4. Relate to Nursing Practice: Identify the nurse’s role in educating and promoting these lifestyle modifications. How can nurses empower patients to adopt and sustain these changes?

5. Support with Evidence: Integrate at least two peer-reviewed scholarly sources published within the last five years. Use APA format for in-text citations and your reference list. 

APA style.

 Read rubric verbatim

 What to Submit

Your submission should include a 2- to 3-page Word document with your reflection, as well as your completed Module Two Decision Analysis Worksheet. For the reflection, include a title page. Use 12-point Times New Roman font, double spacing, and one-inch margins. Sources should be cited according to APA style.

Describe your clinical experience for this week.

• Did you face any challenges, any success? If so, what were they?
• Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
• Mention the health promotion intervention for this patient.
• What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?
• Support your plan of care with the current peer-reviewed research guideline.

Must be On Pediatrics

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

You see a child whose family believes in natural therapy for illnesses (e.g., diet therapy, massage, heat treatments).

How will you incorporate the family’s beliefs into the treatment of a child with an acute upper respiratory infection? With leukemia?

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

Case: Problem Statement

This is an 18-year-old male college student with a history of childhood asthma who presents with acute onset of nonproductive cough, sore throat, fatigue, myalgias, and headache × 4 days. He reports a sick contact, and has not had annual flu vaccine or COVID booster. Physical examination reveals a temperature of 101°F, tachycardia, erythematous pharynx, and anterior cervical lymphadenopathy, but is negative for adventitious breath sounds and hepatosplenomegaly.

Case: Management Plan

Pharmacologic Care:

• Acetaminophen OTC 325 mg 1-2 tabs PO q 4-6 hours; maximum dose 10 tablets per day pm fever, headache, myalgias
• Dextromethorphan HBr + guaifenesin 20mg/400 mg 20 mL PO q 4 hrs; maximum dose 6 doses daily pr cough

Supportive Care:

• Increase fluid intake
• Rest – no class attendance – school note provided for 48 hours
• Marvin Webster Jr i-Human Patients Case Study

Patient Education:

• Offered education on the diagnosis and treatments provided
• Educated patient that oseltamivir is not indicated given timeline since symptom onset

Follow-Up/Disposition:

• Follow up in the student health center if not improving within 48 hours or headache worsens or if shortness of breath develops
• At future visit, address vaccination status – encourage flu vaccine and COVID booster
• Marvin Webster Jr i-Human Patients Case Study

due Jan 17

• Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program?
• Who is your target population?
• What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples?
• What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
• What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples?
• Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

The purpose of this assignment is to develop a presentation for your capstone project change proposal that you will present in Topic 10 to leaders and interprofessional stakeholders at your practicum site.

Prepare a presentation using as a guide the Topic 8 “Benchmark – Capstone Project Change Proposal” that was completed previously.

Students will disseminate this presentation to leadership at the practicum site in Topic 10. Reach out to your preceptor to collaborate on confirming a date and time to present this PowerPoint to an interprofessional audience of leaders and stakeholders at the practicum site.

Prepare a 10-15-slide PowerPoint presentation of your capstone project change proposal to include the following:

1. Identify the clinical problem statement and explain the purpose of the evidence-based change proposal.
2. Summarize the evidence/literature, including connection to the proposed plan.
3. Propose an implementation plan with an intervention and outcome measures.
4. Outline the roles and responsibilities of the various interprofessional stakeholders who will be needed in order to implement the plan. Roles and responsibilities discussed should be specific to the implementation of your proposed project.
5. Describe the resources needed for project implementation.
6. Discuss the evaluation plan for proposed nursing intervention.

Provide a minimum of three references to accompany in-text citations used throughout the PowerPoint presentation.

In preparing your presentation, consider the stakeholders who will be part of your audience and ensure you incorporate appropriate messaging and communication strategies for that audience. Submit the presentation in the digital classroom for feedback from the instructor.

Title slide and reference slide are not included in the slide count. Include speaker notes below each content-related slide that represent what would be said if giving the presentation in person. Expand upon the information included in the slide and do not simply restate it. Please ensure the speaker notes include a minimum of 50-100 words per slide.