How does the community health nurse recognize bias, stereotypes, and implicit bias within the community? How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue. Cite and reference the article in APA format.

Depression is widespread among elderly, and usually it is undiagnosed and treated. generally, SSRIs such as Fluoxetine, Citalopram and Escitalopram tend to be the most commonly prescribed antidepressants for patient with major depression. SSRIs should be prescribed for this patient because this drug has reduced risk of pharmacokinetic interactions. Also, safety and side effect profiles of this drug makes one of the best choices among depression drugs. Further more, SSRIs are generally are better tolerated than other drugs that treat depression.  (Birrer et al., 2004). 

It is very important you let the patient know that antidepressants drugs such as SSRIs start to work within 2 weeks of when you start taking them. But it usually takes at least 4 to 6 weeks before you get the full effect, and might take as long as 12 weeks. (Birrer et al., 2004). Also, you might have minor side effect such as feeling anxious, feeling tired, dry mouth, problem with sex, nausea, diarrhea, or constipation and if that happens continue taking the drugs.

Some of the positive changes that can be seen on patient taking antidepressants medicating are improved concentration and improved though process. Patient will see improvement on their sleep pattern. But, if patient doesn’t see any improvement taking this drug, the prescriber should try increase the dose or switch different  type of antidepressant. ( Shelton et al., 2001) 

Reference 

Birrer, B., & Vemuri., P. ( 2004, May) Depression in Later Life: A Diagnostic and 

 Submit a 1,000-word paper that addresses your career trajectory and opportunities for advancement. Specifically: 

• Name and describe the purpose of a professional organization you may be interested in joining. Explain the organization’s benefits, such as working groups, continuing education, and/or job banks or listings. Considering these offerings from the organization, explain why membership would be valuable for your professional development and professional goals.

USE THE:  American Organization for Nursing Leadership 

• Identify a professional certification that interests you and explain why. Describe the benefits of and requirements for certification. Explain your plans for obtaining this certification. 

USE THE: CCRN OR CRITICAL CARE RN certificate 

• Share a statement about your current ambitions that include at least two goals related to your specialty area. Describe your intended involvement in scholarship, leadership, and/or lifelong learning. Explain how you can capitalize on your knowledge and skills to be an effective agent of social change.

 USE THE:  Area for Nursing Executive 

• Explain how you will search for a nurse executive position, including the resources and strategies used. Describe what you will highlight from your practicum experience in an interview and/or resume. How can the completed Professional Portfolio be used as a tool to advance your career? How might you use it during the interview process?

• Explain how influential nurse leaders, such as your Preceptor, can assist in advancing your career trajectory.

Social Media and the Modern Impact of Informatics

Write an essay addressing each of the following points/questions. Be sure to completely answer all the questions for each number item. There should be three sections, one for each item number below, as well the introduction (heading is the title of the essay) and conclusion paragraphs. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) scholarly citations using APA citations in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount. Review the rubric criteria for this assignment.

1. Most people remember the story below that made national headlines. As most Americans have smart phones, tablets, and computers the utilization of social media is common place.
   1. Finley, T. (2017, Sept. 20). Navy hospital removes staffers for calling babies ‘mini Satan’s’ on social media. Parenting.
      1. If you were writing a hospital policy on smart phone and social media usage, what should be included in the policy?
      2. What potential ethical and legal liabilities are there for the hospital and employees in the case presented above?
2. In 2007, Harvard University rescinded admission to 10 students after reviewing their social media post.
   1. Do you feel potential employers, current employers, and colleges have the right to access your social media post? Do you feel employers and universities should make decisions based on your post?
3. Discuss the relationship between accreditation decisions, reimbursement, quality of care, informatics.

Assignment Expectations

Length: 500 words per essay prompt/section (1500 total for this assignment)

Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment. All APA Papers should include an introduction and conclusion. 

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf)

Instructions

Course Project—Part 1

In a Microsoft Word document of 5-6 pages formatted in APA style, develop
the introduction for your project. Develop three lesson plans as part of an instructional unit on a subject of your choice focusing on one disease. The project will contain one lesson plan focused on education of a patient, one on family education, and one on staff development. The plans should demonstrate a logical approach to teaching, communicate what is to be taught and how, and outline how objectives are to be evaluated. Give a description of your educational setting for each learner. Please make sure that you have evidence-based research (i.e., journal articles) as well.

Be sure to focus on one (1) disease but three (3) audiences (patient, family and staff development/novice nurse). 

The introduction should:

·  Contain the title of the lesson.

·  Identify and describe the learners.

·  Describe the educational setting:

• Staff development
• Patient education
• Family education

·  Include learner assessments:

• Educational level
• Developmental level
• Readiness to learn, and so forth.

·  Provide a purpose and rationale for selecting the topic/disease.

·  Describe the philosophical or theoretical basis for teaching approaches used in the lesson.

·  Support criteria with relevant examples and journal articles.

Please note that the title and reference pages should not be included in the total page count of your paper. 

On a separate references page, cite all sources using APA format. Helpful APA guides and resources are available in the  University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the  University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

• APA Citation Helper
• APA Citations Quick Sheet 
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template

Most patients with mental health disorders are not aggressive. However, it is important for nurses to be able to know the signs and symptoms associated with the five phases of aggression, and to appropriately apply nursing interventions to assist in treating aggressive patients. Please read the case study below and answer the four questions related to it.

Aggression Case Study

Christopher, who is 14 years of age, was recently admitted to the hospital for schizophrenia. He has a history of aggressive behavior and states that the devil is telling him to kill all adults because they want to hurt him. Christopher has a history of recidivism and noncompliance with his medications. One day on the unit, the nurse observes Christopher displaying hypervigilant behaviors, pacing back and forth down the hallway, and speaking to himself under his breath. As the nurse runs over to Christopher to talk, he sees that his bedroom door is open and runs into his room and shuts the door. The nurse responds by attempting to open the door, but Christopher keeps pulling the door shut and tells the nurse that if the nurse comes in the room he will choke the nurse. The nurse responds by calling other staff to assist with the situation.

1. What phase of the aggression cycle is Christopher in at the beginning of this scenario? What phase is he in at the end the scenario? (State the evidence that supports your answers).

2. What interventions could have been implemented to prevent Christopher from escalating at the beginning of the scenario?

3. What interventions should the nurse take to deescalate the situation when Christopher is refusing to open his door?

4. If a restrictive intervention (restraint/seclusion) is used, what are some important steps for the nurse to remember?

SCHOLAR NURSING ARTICLE>>>APA FORMAT>>>

Copy and paste no references

1. What changes in veins occur to create varicose veins?
2. What is the disease process with superior vena cava syndrome?
3. How does atherosclerosis cause an aneurysm?
4. What are the differences between healthy vessel walls and those that promote clot formation?
5. What are the causes of pulmonary emboli?
6. What can trigger an immune response within the bloodstream that can result in an embolus?
7. Describe thromboangiitis obliterans (Buerger disease).
8. Describe Raynaud disease.
9. What is the cause of the hypertrophy of the myocardium associated with hypertension?
10. What pathologic change occurs to the kidney’s glomeruli as a result of hypertension?
11. What is the primary mechanism of atherogenesis?
12. What is the effect of oxidized low-density lipoproteins (LDLs) in atherosclerosis?
13. Which inflammatory cytokines are released when endothelial cells are injured?
14. What alteration occurs in injured endothelial cells which contributes to atherosclerosis?
15. Differentiate between ischemia and infarction.
16. Which of the lipids is manufactured by the liver and primarily contains cholesterol and protein?
17. Which elevated lipid value may be protective of the development of atherosclerosis?
18. What are the risk factors for developing coronary artery disease?
19. Which risk factor increases the risk of developing coronary artery disease up to threefold?
20. How does nicotine increases atherosclerosis?
21. Which lab test is an indirect measure of atherosclerotic plaque?
22. Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes?
23. Which form of angina occurs most often during sleep as a result of vasospasms of one or more coronary arteries?
24. What is the expected electrocardiogram pattern for a person when a thrombus in a coronary artery lodges in the vessel and the infarction extends through the myocardium from the endocardium to the epicardium?
25. How does angiotensin II increase the workload of the heart after a myocardial infarction?
26. How long after a myocardial infarction is the scar tissue that forms most vulnerable to injury?
27. What are the enzyme indicators of a myocardial infarction?
28. A patient complains of sudden onset of severe chest pain that radiates to the back and worsens with respiratory movement and when lying down. These clinical manifestations are indicative of which disease?
29. What is the significance of the pulsus paradoxus that occurs as a result of pericardial effusion?
30. Biventricular dilation is the result of which form of cardiomyopathy?
31. Which form of cardiomyopathy is characterized by ventricular dilation and grossly impaired systolic function, leading to dilated heart failure?
32. The hallmark of which form of cardiomyopathy is a disproportionate thickening of the interventricular septum?
33. Which form of cardiomyopathy is usually caused by an infiltrative disease of the myocardium, such as amyloidosis, hemochromatosis, or glycogen storage disease?
34. Which are the clinical manifestations of aortic stenosis?
35. Aortic and mitral regurgitation as well as mitral stenosis are caused by which common disease?
36. Which predominantly female valvular disorder is thought to have an autosomal dominant inheritance pattern, as well as being associated with connective tissue disease?
37. Which disorder causes a transitory truncal rash that is nonpruritic and pink with erythematous macules that may fade in the center, making them appear as a ringworm?
38. Infective endocarditis is most often caused by which type of microorganism?
39. What are risk factors for infective endocarditis?
40. What is the most common cardiac disorder associated with acquired immunodeficiency syndrome (AIDS) resulting from myocarditis and infective endocarditis?
41. What contributes to the physiologic changes that mediate ventricular remodeling?
42. In systolic heart failure, what effect does angiotensin II have on stroke volume?
43. A patient is diagnosed with pulmonary disease and elevated pulmonary vascular resistance. Which heart failure may result from this condition?

Chapter 34: Alterations of Cardiovascular Function in Children

Study Questions

1. When does most cardiovascular development occur?
2. What is the function of a patent opening between the left and right atria in a fetus?
3. At birth what is the most important change that takes place?
4. The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the _____ to the _____.
5. When does systemic vascular resistance in infants begin to rise?
6. Congenital heart defects that cause acyanotic congestive heart failure usually involve what kind of shunt?
7. Congenital heart defects that cause hypoxemia, and therefore cyanosis, usually involve what kind of shunt?
8. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?
9. An infant has a continuous-machine type of murmur best heard at the left upper sternal border throughout systole and diastole. The infant has a bounding pulse and a thrill on palpation. These clinical findings are consistent with which congenital heart defect?
10. The infant diagnosed with a small patent ductus arteriosus (PDA) is likely to present with what clinical manifestations?
11. An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. There is also a wide fixed splitting of the second heart sound. These clinical findings are consistent with which congenital heart defect?
12. An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?
13. How do children with tetralogy of Fallot compensate to relieve hypoxic spells?
14. What is the location coarctation of the aorta (COA)?
15. Classic manifestations of a systolic ejection murmur, cyanosis of the lower extremities, and decreased or absent femoral pulse are indicative of an older child with which congenital defect?
16. What is the most important clinical manifestation of aortic coarctation in the neonate?
17. Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click?
18. Which heart defect produces a systolic ejection click at the upper left sternal border with a thrill palpated at the upper left sternal border?
19. Describe the cardiac defect of transposition of the great vessels.
20. Describe the cardiac defect of total anomalous pulmonary venous return.
21. Which heart defect results in a single vessel arising from both ventricles providing blood to both the pulmonary and systemic circulations?

Both the DNP prepared nurse and PhD prepared nurse have valuable and vital roles within the healthcare field.  PhD prepared nurses are skilled in the area of research methods, such as quantitative, qualitative, and mixed research methods (Trautman, Idzik, Hammersla & Rosseter, 2018), therefore are research centered.  PhD prepared nurses are defined as linking research, teaching, and practice within the nursing profession (Andreassen & Christensen, 2018).  According to a quantitative study by Andrerassen & Christensen the number of PhD nurses is growing worldwide.  A priority of the PhD nurse is to complete practice based research with a goal to maintain a positive overall impact on patient care. 

   The DNP program was intended to prepare the advanced practice nurse to become a leader in a clinical practice setting (McCauley, Broome, Frazier, Hayes, Kurth, Musil, Norman, Rideout & Villarruel, 2020), therefore is more focused on clinical practice.  DNP prepared nurses often find themselves bridging the gap between research and the bedside (Trautman et al., 2018).  DNP nurses lead quality improvement initiatives while utilizing data to translate research into evidence based practice (Trautman et al., 2018).  Over the years the number of DNP programs available for one to enhance their education has grown.  DNP nurses complete coursework involving assessments of the most up to date technologies available to prescribers and will be prepared to apply this technology in the workforce to solve various problems (McCauley et al., 2020), such as solving emerging problems during this pandemic.   

   Both roles (DNP and PhD) aim at improving one’s healthcare services and wellbeing also are degrees of the highest level of nursing practice.  The goal of both the DNP and PhD prepared nurse is to have a positive patient care outcome.   Nurses have the opportunity to obtain either a PhD or DNP while expanding their knowledge in the healthcare field.  Overall this is a great opportunity,  one is able to choose what career path most suits them and their career goals.  I am excited to take advantage of this educational pathway with a goal to practice in a PMHNP role leader position.  I fully intend to  pursue my career in the mental health field and strengthen my clinical practice skills.   

                                                                                        References

Andreassen P., & Christensen M.K. (2018). “We’re at a watershed”: The positioning of PhD 

nurses in clinical practice. Journal of  Advanced Nursing, 74(8), 1–11. doi.org/ 10.1111/jan.13581

McCauley, L. A., Broome, M. E., Frazier, L., Hayes, R., Kurth, A., Musil, C. M., Norman, L. D., 

Rideout, K. H., & Villarruel, A. M. (2020). Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track. Nursing outlook, 68(4), 494–503. https://doi.org/10.1016/j.outlook.2020.03.008

Trautman, D.E., Idzik, S., Hammersla, M., Rosseter, R., (2018). Advancing Scholarship through 

Translational Research: The Role of PhD and DNP Prepared Nurses. OJIN: The Online Journal of Issues in Nursing, 23(2) 1-1. doi: 10.3912/OJIN.Vol23No02Man02

Students will:

• Apply documentation skills to examine family therapy sessions *
• Develop diagnoses for clients receiving family psychotherapy *
• Analyze legal and ethical implications of counseling clients with psychiatric disorders *

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 3.

Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session.

Then, address in your Practicum Journal the following:

• Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session.
• Describe (without violating HIPAA regulations) each client, and identify any pertinent history or medical information, including prescribed medications.
• Using the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM-5), explain and justify your diagnosis for each client.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

1) Minimum 10 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

              Part 1: Minimum 1 page

              Part 2: minimum 1 page

              Part 3: minimum 1 page

              Part 4: minimum 1 page 

              Part 5: Minimum 4 pages

             Part 6: minimum 1 page

              Part 7: 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 

__________________________________________________________________________________

Part 1: 

1. What is the significance of evidence-based practice to health care? 

2. Discuss the most reliable evidence-based sources.

Part 2: 

 Topic research proposal :  Knowledge about HIV / AIDS and sexual behavior in adolescents in the San Francisco Community, California.

Now that you have submitted your research proposal and you are preparing to submit your research proposal presentation, 

1. How confident do you feel about developing a research proposal as part of your future career as a nurse researcher? Explain your answer. 

2. What questions or concerns do you still have about conducting research in nursing?

Part 3: 

Select one of the future issues presented this week :  Health Promotion

1. Examine the issue in terms of cultural diversity, health promotion, and communication methods.

2.  Discuss in detail how this issue affects healthcare delivery and advanced nursing. 

Part 4: 

 1. What are the challenges encountered in data collection as it applies to research?

2. What are the types of interview technique when interviewing participants? 

3. List your preferences  of types of interview techniqueand tell us why?

Part 5: 

As discussed earlier in this course, your personal teaching philosophy is a work in progress. You will revisit and revise your teaching philosophy that you submitted (See File 1). As part of this assignment, you should evaluate your original philosophy and include a one-page discussion of how your thoughts and ideas about teaching have changed and developed during this course. Guidelines for revising your teaching philosophy and the one-page discussion are below.

Assignment Guidelines (3 pages)

1. Reflect on the teaching principles and practices discussed during the course.

2. What did you learn about teaching that you did not know prior to this course?

3. What stood out as important to you over the past 8 weeks?

4. Consider how you might expand, adapt, or change your original philosophy to your current perspective on teaching (or you may feel compelled to take it in a completely new direction).

5. Clearly express your current teaching values and beliefs, and discuss why you hold those values and beliefs (whether or not they have changed).

6. Describe your current teaching goals (whether or not they have changed).

7. Explain the teaching methods or strategies that you believe are best (whether or not they are different from your original philosophy). Note: make sure the teaching methods you find best are consistent with your goals.

Discussion evaluating (1 page) how your personal thoughts and ideas about teaching have changed during this course.

Compare your original philosophy (File 1) y to your revised teaching philosophy and evaluate the following in a one-page written discussion:

1. Have your teaching goals, methods, or strategies changed, and if so, how and why? Have your teaching priorities and/or perspectives changed or shifted, and if so, how and why?

2. Do you value different learning experiences, and if so, what are they and why?

3. Include any additional information that may highlight how your thoughts and ideas have changed or developed during this course.

Part 6: 

1. What do you think would be the response of historical nursing leaders such as Florence Nightingale, Lillian Wald, and Mary Breckenridge if they could see what the profession of nursing looks like today?

Part 7: 

The five elements of the nursing process are all incorporated into the patient’s plan of care and revised as the patient’s health status changes.

A patient is admitted with chest pain following a visit with her family health care provider. Using the “OLD CART” method of gathering pertinent data

1. Discuss the type of questions you will be asking this patient in relation to her chest pain.

2. Discuss the five components of the nursing process as it relates to the above patient.