Watch the first 7 minutes from Charged with Manslaughter for a Drug Error.
After reflecting on the video content and reviewing the information in this module, discuss how you, as a nurse, will balance the ethical obligations you have to the patient for safe medication administration with the pressures and policies of healthcare institutions and your nursing workload. Develop a plan on how you will prevent yourself from becoming lax and using shortcuts in the medication administration process.
Research paper of Human Growth and Development, Chapter 2- Module 2.2. This project has to be done in APA style and it will be evaluated in Turnitin. Due day 11/22/2020. I attached two power points with summaries and photos from the book.
Reply separately to two of your classmates Powerpoint / video posts (See both attached classmates Powerpoint, PP#1 Narrative therapy, and PP#2 Feminist Therapy).
Here is a great video explaining what a Feminist therapy is and how it is used. An Overview of Feminist Therapy
https://youtu.be/H3Bx6cWXZBY
Here is a great video explaining what Narrative therapy is and how it is used.
Grande, T. (2018, February 20). What is narrative therapy? [Video]. YouTube. https://www.youtube.com/watch?v=GoMfpmTJ28c&feature=emb_logo
INSTRUCTIONS:
Your responses should be in a well-developed paragraph (300-350 words) to each peer. Integrating an evidence-based resource!
Note: DO NOT CRITIQUE THEIR POSTS, DO NOT AGREE OR DISAGREE, just add informative content regarding to their topic that is validated via citations.
– Utilize at least two scholarly references per peer post.
Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.
– Minimum of 300 words per peer reply.
– TURNITIN Assignment.
Background: I live in South Florida, I am currently enrolled in the Psych Mental Health Practitioner Program, I am a Registered Nurse, I work in a Psychiatric Hospital.
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.
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.
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.
This article provides NPs with information regarding state-based laws for NP prescribing.
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.
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 2 citations APA format 7th editionFUOne patient case from my experience that addresses the principles of pharmacokinetics and pharmacodynamics is where my patient was a 55 years old female, of African American decent, had a history of diabetes, hyperlipidemia, and hypertension. The patient was presented to our hospital with severe nausea, vomiting and abdominal pain. Assessment and lab work showed the patient’s blood glucose was 605mg/dL, HgA1C 8.5%, cholesterol 180 mg/dl, weight 290 lbs, height 68inches, BP 90/75, pulse 118, Respiration 23 bpm. Patient stated she had been very stressed lately and had mostly been dining out at fast-food restaurants and has not had the time to exercise. Patient had been prescribed insulin however, she stated she has not been checking her blood glucose level like she should have. This patient was presenting with symptoms of diabetic ketoacidosis (DKA). DKA is a medical emergency that occurs when the body is unable to produce adequate insulin to decrease blood glucose level and leads to the production of high levels of acids in the blood called ketones (Alshammari et. al., 2017). This was a medical emergency that required immediate intervention of fluid repletion and the administration of insulin. It also involved the frequent monitoring of patient’s vital signs, glucose levels, and electrolyte levels. Factors that might have influenced pharmacokinetics of insulin the patient was receiving are diet (eating fatty foods or foods high in carbohydrates increases glucose levels in the body), stress (cortisol increases insulin resistance), and lack of exercise. Eating a balanced diet decreases the likelihood that the patient will consume mostly foods high in fats and carbohydrates. When someone is stressed, the body produces stress hormones called cortisol which to a diabetic patient can significantly affect their health because it causes the body to release more glucose and to become resistant to the insulin the patient needs to reduce that blood glucose to a healthy level (Alshammari et. al., 2017). Exercise redistributes and lowers the blood glucose level. It could cause patients to go into hypoglycemia that is why it is important to check glucose levels before, during, and after exercise.The personalized care plan that I would develop for this patient would include; a Dietary and lifestyle change plan – here the patient will be educated on how to count her carbohydrates and caloric intake. The Center for Disease Control has dietary guidelines for the different age groups. The site also provides “My Food Diary” (CDC, 2019) a flow sheet to help individuals keep a day-to-day record of how much food is consumed for breakfast, snacks, lunch, and dinner. I would also recommend she exercise regularly but that to check her blood glucose before, during and after exercise. “The adoption and maintenance of physical activity are critical foci for blood glucose management and overall health in individuals with diabetes” (Colberg, 2016). Also, I would suggest she check her blood glucose before each insulin administration, as this may affect the dosage to be administered.
ReferencesAlshammari, A. A., Alahdal, L. M., Jawi, J. T., Alnofaie, H. A., Aldossari, N. A., AbdulazizAlassaf, H. M., Ramel, A. I., Almshikhess, S. H., Felemban, A. S., Alanazi, S. A., Joharji, R. N., Alzahrani, A. M. B., Almaghamsi, S. A. D., Alalawi, M. S. M., Alasmari, H. I., Abduljabbar, A. M., & alzahrani, A. fahad. (2017).
First Line Management of Adult Diabetic Ketoacidosis Patients. Egyptian Journal of Hospital Medicine, 67(2), 571–577. https://doi-org.ezp.waldenulibrary.org/10.12816/0037808
Centers fo Disease Control and Prevention [CDC], 2019. Eating Out. Retrieved from https://www.cdc.gov/diabetes/managing/eat-well.htmlColberg, S.R., Sigal, R. J., Yardley, J. E., Riddle, M.C., Dunstan, D.W., Dempsey, P.C., … & Tate, D.F. (2016).
Physical activities/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes care, 39(11), 2065-2079
I need a response for the following peer
Breast Lump Case Study
The case involves a 37-year-old woman, gravida 2 para 2, who presents to the clinic with a chief complaint of a lump in her left breast. Her family is positive for breast cancer. Both children, aged 9 and 7, are alive and delivered without complications. She has a healthy weight (BMI 22), and does not smoke, but drink a glass of wine most evening with supper. She has regular physicals and is up to date with smears. A physical examination revealed a firm lump near the surface with no masses. The lump was aspirated, removing an opaque liquid. The aspiration vanished the lump.
The most probable diagnosis is a breast cyst. Cysts are formed by the accumulation of fluid inside the breast glands. A majority of cystic lesions are benign while the majority of solid lesions are malignant. Most breast cysts are small (5 mm to 20 mm) and painless. They are strongly influenced by hormones and are common in women of childbearing age. While a breast cyst is palpable, it can be confused with a solid mass. Therefore, one of the fundamental approaches is a fine-needle aspiration biopsy. The aspirated fluid does not contain blood or other cystic components. However, if it contained blood, it would have been critical to send the fluid for cytology and consultation from a surgeon.
Further evaluation of the breast lump or mass is guided by findings on history, physical examination, imaging, and biopsy. In this case, a triple test of clinical breast exam, ultrasonography, and needle biopsy may be necessary to find a definitive diagnosis. Based on the extent of clinical suspicion, the practitioner should order mammography before a pathologic diagnosis. Mammography is essential in the evaluation of palpable lesions. However, if the lump is suggestive of a fibroadenoma by ultrasound and mammography, short-term follow-up and re-imaging are essential. Fibrocystic changes present on a mammogram as round or oval, well-defined masses. A biopsy is also necessary to identify whether the cysts are malign. Complex cysts with both fluid and solid matter necessitate biopsy (Brown, Phillips, Slanetz, Fein-Zachary, Venkataraman, Dialani & Mehta, 2017). The fine needle aspiration provides sufficient cellular material to facilitate adequate cytologic evaluation. However, core biopsy is recommended because it uses a large cutting needle that allows the collection of tissues suitable for histologic analysis that is familiar to most pathologists.
Breast cysts do not increase the risk of breast cancer. According to Lin, Peng, and He (2018), cysts, including complex cysts have a low risk of breast cancer. However, benign breast diseases (BBD) are not life-threatening, some may increase the risk of breast cancer. Cysts are classified as non-proliferative disorder and their absolute risk of causing cancer is estimated to be 2% (Stachs, Stubert, Reimer & Hartmann, 2019). Etiologically, cysts are associated with fibrocystic changes. More than 50% of women develop symptomatic fibrocystic changes in their lifetime. Fibrocystic changes are caused by hormonal changes and are common in women between 20 and 59 years. Breast cancer risk factors are numerous and diverse, including age (65 years and above), atypical hyperplasia, history of early-onset breast cancer, high postmenopausal endogenous estrogen, and high-dose radiation to the chest.
However, it is important to consider her family history of breast cancer. A hereditary predisposition to breast cancer increases the risk of developing breast cancer at a younger age. Therefore, early identification of patients with a hereditary predisposition is vital to exploit the numerous opportunities provided by enhanced surveillance, chemoprevention, and risk-reducing surgery. Patient can be counseled on breast self-examination and a follow-up schedule established. Follow-up is critical in detecting missed cancer. During the follow-up, it is fundamental to evaluate recurrent masses or fluid.
Scenario
The scarcity of health resources continues to negatively affect communities across the country. Deciding how to allocate scarce resources creates significant ethical challenges for local policymakers and other stakeholders within the community.
You represent a local non-profit community health organization in Chicago. Your organization is compiling data to conduct a needs assessment in order to determine the feasibility of a new community-based mobile health clinic. You have been asked to review the most recent strategic plan for the city of Chicago.
The mobile clinic would offer free preventive care, urgent care, and chronic disease management services to vulnerable citizens of Chicago, who may not otherwise have the financial resources to access quality healthcare services. Your executive summary will be used in the development of a needs assessment for the project.
Your targeted population is an urban, low income community disenfranchised by current health reform policies, high unemployment, a shortage of primary care physicians, and divisive partisan attitudes regarding entitlement programs. The goal of the community-based clinic is to work collaboratively with local health facilities to reduce costs, improve access, and to enhance the quality of care for underserved communities.
Review the community health needs assessment linked here
that was conducted by the Health Impact Collaborative of Cook County. Pages 37 – 49 of the report highlight challenges facing the city with respect to costs, access, and quality of care issues.
Write an executive summary addressing the following questions:
What are some of socio-economic factors that affect access to care based on the findings in the report?
What are the critical focus areas identified in the report?
Based on the report’s content, how might the use of a mobile health clinic address the critical focus areas?
What are some of the potential barriers to success for a mobile health clinic?
APA formatting for the reference list, and proper grammar, punctuation, and form are required.
1) Minimum 1 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)
Part 1: Minimum 1 page
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
5) Identify your answer with the numbers, according to the question.
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
__________________________________________________________________________________
See PPT Ch07
The nurse is completing a cardiovascular assessment on a patient diagnosed with orthostatic hypotension.
1. Identify what can result in a false high or false low blood pressure reading.
Based on specific medical conditions, the nurse may assess variations in vital signs.
2. Discuss medical conditions that are associated with variations in a person’s vital signs.
In an essay of 1500 to 2000 words, using at least 2 APA style cited references, write an essay in APA style on:
PLEASE FOLLOW THE REQUIREMENT STEP BY STEP
This paper should clearly and comprehensively discuss a chronic health disease.
Week 6 Paper: Cystic Fibrosis
The data should reflect the United States. My state is Maryland, My county is Howard, My city is laurel
The paper should be organized into the following sections:
TEXTBOOK: Curley, L. A., & Vitale, A. P. (2016). Epidemiological Methods and Measurements in Population-Based Nursing Practice: Part II. In Population-Based Nursing, Concepts and Competencies for Advanced Practice (2nd ed.
